1.The influence of obesity on the outcomes of endoscopic spinal surgery: a meta-analysis
Jose Luis BAS ; Jorge CAMPOS ; Gonzalo MARISCAL ; Hashem ALTABBAA ; Paloma BAS ; Teresa BAS
Asian Spine Journal 2025;19(6):1045-1058
Obesity is an escalating health problem that has been increasingly associated with surgical complications. In general, open surgical techniques worsen these complications, because they are more tissue-destructive and associated with a relatively long recovery period. Minimally invasive techniques, such as endoscopic spine surgery, appear to be good substitutes, because they reduce tissue iatrogenic injury and hasten recovery. However, the effect of obesity on the performance of endoscopic spine surgery remains uncertain. This metaanalysis was designed to evaluate the safety and efficacy of endoscopic spine surgery in patients with obesity compared with those without obesity. This study adhered to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. We conducted a thorough search using PubMed, Scopus, and Virtual Health Library. Methodological quality was assessed using the MINORS (Methodological Index for Non-randomized Studies) criteria. Mean differences (MD) and standardized mean differences with 95% confidence intervals (CI) were calculated. Statistical analyses were conducted using Review manager ver. 5.4.1. Seven studies involving 659 participants were analyzed. The obese and nonobese groups had no significant differences in operative time (MD, 9.86 minutes; 95% CI, −4.93 to 24.65); Visual Analog Scale (VAS) scores for back pain at 3 months (MD, 0.26; 95% CI, −0.11 to 0.63), 6 months (MD, 0.26; 95% CI, −0.05 to 0.56), and 12 months (MD, −0.54; 95% CI, −1.70 to 0.62); VAS leg pain scores at 3 months (MD, 0.17; 95% CI, −0.06 to 0.41), 6 months (MD, 0.23; 95% CI, −0.13 to 0.59), and 12 months (MD, 0.18; 95% CI, −0.10 to 0.45); Oswestry Disability Index scores at 3 months (MD, 1.02; 95% CI, −0.14 to 2.18) and 12 months (MD, 0.10; 95% CI, −1.14 to 1.33); and reherniation rate (odds ratio, 1.35; 95% CI, 0.73 to 2.49). Endoscopic surgery demonstrated no significant differences in outcomes between obese and nonobese patients and was safe and effective for this patient population.
2.Clinical and anatomic description of patients with arteriovenous malformation treated with endovascular therapy in a Mexican population
Mallyolo Eliezer PELAYO-SALAZAR ; Héctor Alfredo MONTENEGRO-ROSALES ; Jorge Luis BALDERRAMA-BAÑARES ; Pablo MARTÍNEZ-ARELLANO ; Omar Andrés CAMPOS-FLOTA ; Laura MESTRE-OROZCO ; Julio César LÓPEZ-VALDÉS
Journal of Cerebrovascular and Endovascular Neurosurgery 2023;25(1):36-49
Objective:
Arteriovenous malformations (AVMs) are benign congenital lesions. The estimated prevalence is 10-18 per 100,000 individuals, with an incidence rate of 1.1-1.4 per 100,000 person-year; only 12% of AVMs present symptoms during life. It is important to study different characteristics associated with AVMs because these patients require multidisciplinary treatment.
Methods:
A descriptive, observational, longitudinal, and retrospective study was carried out from January 15, 2016 to October 19, 2021. Convenience sampling was used on patients diagnosed with arteriovenous malformation. Sociodemographic data was obtained, such as: sex, age, site, predominant symptoms, clinical debut, type of malformation, data associated with post therapy evolution, type of embolizing agent used, associated complications, Rankin scale, and death.
Results:
Data from 535 procedures was collected, we calculated an incidence of 4.4 cases per million inhabitants. Ninety procedures in 56 patients that used endovascular therapy were obtained with a female-male ratio of 0.75 and an age distribution of 35±14 (SD). A 36.3±11.5 (SD) mm diameter was registered. There was a 33% success rate for endovascular surgery.
Conclusions
The multidisciplinary treatment of AVMs is made up of three pillar techniques: microsurgical resection, embolization, and radio-neurosurgery. It is extremely important to make an appropriate decision, with an emphasis on achieving better functional outcomes for the patient. Although neurological endovascular therapy was initially used as an adjuvant treatment for neurosurgery and radio-neurosurgery, it has been used more and more frequently as the first line of treatment.

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