Evidence map›Paper›PMID 39595825›Full record

ReviewBrain sciences2024

Evolution of Thoracic Disc Herniation Surgery: Future Perspectives from a Systematic Review and Meta-Analysis.

Giuseppe Corazzelli, Sergio Corvino, Giulio Di Noto, Chiara Di Domenico, Federico Russo, Giuseppe Mariniello, Andrea Elefante, Antonio Bocchetti, Sergio Paolini, Vincenzo Esposito and 3 more

Abstract readReview
In one paragraph

Review in Brain sciences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Giuseppe CorazzelliDepartment of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University of Naples "Federico II", 80131 Naples, Italy.ORCID 0000-0002-8536-6962
Sergio CorvinoDepartment of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University of Naples "Federico II", 80131 Naples, Italy.ORCID 0000-0003-4918-6857
Giulio Di NotoDivision of Neurosurgery, Università degli Studi di Messina-Policlinico "G. Martino", 98124 Messina, Italy.
Chiara Di DomenicoDepartment of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University of Naples "Federico II", 80131 Naples, Italy.
Federico RussoDepartment of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University of Naples "Federico II", 80131 Naples, Italy.
Giuseppe MarinielloDepartment of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University of Naples "Federico II", 80131 Naples, Italy.
Andrea ElefanteDepartment of Advanced Biomedical Sciences, University of Naples "Federico II", 80138 Naples, Italy.ORCID 0000-0002-9093-7096
Antonio BocchettiNeurosurgery Department, Santa Maria delle Grazie Hospital, ASL Napoli 2 Nord, 80078 Naples, Italy.
Sergio PaoliniDepartment of Neurosurgery, IRCCS Neuromed, 86077 Pozzilli, Italy.
Vincenzo EspositoDepartment of Neurosurgery, IRCCS Neuromed, 86077 Pozzilli, Italy.ORCID 0000-0001-7316-5461
Gualtiero InnocenziDepartment of Neurosurgery, IRCCS Neuromed, 86077 Pozzilli, Italy.
Raffaele de FalcoNeurosurgery Department, Santa Maria delle Grazie Hospital, ASL Napoli 2 Nord, 80078 Naples, Italy.
Oreste de DivitiisDepartment of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University of Naples "Federico II", 80131 Naples, Italy.ORCID 0000-0001-7265-5418

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe neurosurgical treatment of thoracic disc herniation (TDH) has undergone dramatic changes over the years in terms of surgical approaches and intraoperative technological tools. There is still no unanimous consent on the criteria for approach selection, and the choice varies among Institutions. The aim of this study is to compare anterior and posterolateral approaches for TDH in terms of functional and surgical outcomes.

methodsA systematic literature review and meta-analysis according to PRISMA guidelines from EMBASE, PubMed, Cochrane Library, Web of Science, and Google Scholar online databases up to May 2024 incorporated studies that reported outcomes of thoracic disc herniation surgeries. Analyzed factors included major peri- and postoperative complications, intraoperative blood loss, hospital stay, neurological improvement, and complete hernia resection. Random-effect models were used to calculate pooled odds ratios and mean differences.

resultsThe posterolateral approach was associated with significantly lower rates of major medical (OR 0.14, 95% CI: 0.07 to 0.27) and surgical complications (OR 0.61, 95% CI: 0.38 to 0.99) compared to the anterior approach. Additionally, posterolateral approaches reduced intraoperative blood loss and shorter hospital stays. Posterolateral techniques were linked to higher odds of neurological improvement (OR 0.65, 95% CI: 0.43 to 0.99) and higher rates of complete hernia resection (OR 0.38, 95% CI: 0.21 to 0.71).

conclusionsPosterolateral approaches offer advantages in terms of safety, recovery, neurological improvement, and complete hernia resection. More extensive prospective studies are needed to confirm these findings and refine surgical strategies. Emerging technologies, such as the exoscope and 45° endoscopy, may further enhance surgical outcomes.

Indexed as

anterior approachmeta-analysisminimally invasive surgeryposterolateral approachspinal surgerysurgical complicationsthoracic disc herniation

Identifiers

PMID39595825
PMCPMC11591945

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.