Lumbar interbody fusion is widely employed to treat degenerative spinal conditions. The procedure frequently involves the use of intervertebral cages to enhance segmental stability and facilitate spinal fusion. While bilateral cage placement has traditionally been the standard approach, recent studies have questioned its routine use. This meta-analysis aimed to determine whether unilateral cage placement offers comparable safety and efficacy to bilateral placement in lumbar interbody fusion. A comprehensive search of PubMed, Scopus, and Cochrane databases identified eight eligible randomized control trials involving 509 patients. The primary outcome was the spinal fusion rate. Secondary outcomes included surgery-related outcomes (operative time, estimated blood loss, length of stay), patientreported outcomes VAS, ODI, patient satisfaction), and complications. The analysis revealed no significant differences in successful spinal fusion rates between the two groups (p =0.41). Unilateral cage placement was significantly associated with shorter operation time (p <0.0001) and reduced estimated blood loss (p <0.0001). However, the length of hospital stay was not significantly affected by the number of cages used (p =0.05). Patient-reported outcomes, including Visual Analog Scale (VAS) for back pain (p =0.61), VAS for leg pain (p =0.64), Oswestry Disability Index score (p =0.18), and patient-reported rate of successful clinical outcomes (p =0.55), exhibited no substantial differences between the two groups. Patients in the unilateral group exhibited a lower overall risk of complications (p =0.03), but no difference in the risk of cage migration was noted between the two groups (p =0.97). Unilateral cage placement for lumbar interbody fusion is as effective as bilateral cage placement in achieving fusion, without compromising patient outcomes. Furthermore, it offers significant advantages, such as decreased operative time, blood loss, and complication risk.

OBJECTIVE: The economic crisis and the implementation of austerity measures in Greece lead to significant socioeconomic changes. The effects of the crisis were mainly felt by the Greek population during the years 2011 and 2012. This study aimed to investigate the impact of Greece's economic crisis on the seasonality of suicides in the Athens Greater Area. METHODS: Data were collected for all recorded cases of suicides committed over a 5-year period (from 2008 to 2012) from the Athens Department of Forensic Medicine. Two sub-periods were studied in relation to the economic crisis: 2008–2010 and 2011–2012. Seasonality was estimated with the Poison regression variant of the circular normal distribution. RESULTS: Suicide seasonality appeared significant during 2008–2010 (relative risk, RR=1.36) and strengthened in the years 2011–2012 (RR=1.69), when the impact of the austerity measures was increasingly being felt by the Greek society. Regarding the latter sub-period, seasonality was established for males (RR=1.75), individuals aged 45 years or more (RR=1.75) and suicide by hanging (RR=1.96). CONCLUSION: The economic crisis in Greece, especially in the period during its effects had a significant impact on the population's economic condition, seems to have strengthened the seasonality of suicides, while a noteworthy suicide risk of 96% was revealed for suicides by hanging (peak in early June).
Forensic Medicine ; Greece* ; Humans ; Male ; Seasons* ; Suicide*

OBJECTIVE: To study the characteristics of a sample of suicide victims from the Athens Greater Area using the psychological autopsy method for the first time in Greece. METHODS: We studied all recorded cases of completed suicide for the 2-year time period November 2007-October 2009 collecting data from the victims' forensic records as well as from the completion of a psychological autopsy questionnaire. RESULTS: 335 persons were recorded as suicide victims. We contacted relatives of 256 victims interviewing those of 248 of them (96.9%). The differences regarding sex, marital and employment status between our sample and the general population were statistically significant (p<0.001). The male/female ratio was 3:1. Comparatively more victims were divorced, separated or single and a greater proportion were pensioners or unemployed. 26.0% of the victims had history of prior attempts (64.4% once, 20.3% twice and 15.3% more times). 42.6% were taking psychiatric medication-significantly more women than men according to blood tests; 14.2% had been hospitalized in a psychiatric clinic the year prior to their death. 84.8% have deceased at the place of suicide and 15.2% died in the hospital; 80.3% died indoors and 19.7% outdoors. Men died primarily by hanging or shooting by a firearm while women preferred jumping from height instead (p<0.001). As many as 48.8% had expressed their intention to die to their relatives; 26.6% left a suicide note. CONCLUSION: Our study has shown that the psychological autopsy method is applicable and widely accepted yielding results comparable to the international literature. Specific parameters associated with suicide have been studied for the first time in Greece.
Autopsy* ; Divorce ; Employment ; Female ; Greece* ; Hematologic Tests ; Humans ; Intention ; Male ; Pensions ; Surveys and Questionnaires ; Suicide*