Outcomes and adverse events for spinal synovial cysts surgical treatment: a systematic review and meta-analysis.

BACKGROUND: Spinal synovial cysts (SSCs) are a rare cause of nerve root and spinal cord compression. Surgical excision of SSCs remains the mainstay of treatment in the presence of unremitting symptoms or neurological deficits, but the choice of the surgical approach remains controversial. The goal of this study was to compare clinical outcomes and adverse events associated with traditional approaches (interlaminar or laminectomy/hemilaminectomy) and minimally invasive approaches (microsurgical tubular approaches or endoscopic approaches) for SSCs. METHODS: Studies reporting surgical management of SSCs were searched in three online databases (PubMed, the Cochrane Library, and Web of Science). This meta-analysis was reported following the PRISMA Statement. It was registered at the International Prospective Register of Systematic Reviews (CRD42021288992). The Cochrane Collaboration's Risk of Bias in Nonrandomised Studies-of Interventions (ROBINS-I) was used to evaluate bias. Extracted research data were statistically analyzed using Stata 16 and SPSS statistics 25. RESULTS: A total of 22 related relevant studies were included. Meta-analysis revealed no statistically significant difference in dural tear, residual cyst, recurrence, reoperation, and operation time between minimally invasive approaches and traditional approaches (p > 0.05), but minimally invasive approaches had a good functional improvement (p = 0.004). Postoperative length of hospital stays and intraoperative bleeding in traditional approaches were also higher than in minimally invasive approaches (p < 0.05). CONCLUSION: Based on the available evidence, minimally invasive approaches may be better than traditional approaches in the treatment of SSCs. Minimally invasive approaches had the advantages of improving clinical satisfaction, with a similar complication rate to traditional approaches. Moreover, endoscopic and microsurgical tubular approaches had similar outcomes.

Interferon-γ inducible protein 30 promotes the epithelial-mesenchymal transition-like phenotype and chemoresistance by activating EGFR/AKT/GSK3ß/ß-catenin pathway in glioma.

AIMS: Previous studies have indicated that IFI30 plays a protective role in human cancers. However, its potential roles in regulating glioma development are not fully understood. METHODS: Public datasets, immunohistochemistry, and western blotting (WB) were used to evaluate the expression of IFI30 in glioma. The potential functions and mechanisms of IFI30 were examined by public dataset analysis; quantitative real-time PCR; WB; limiting dilution analysis; xenograft tumor assays; CCK-8, colony formation, wound healing, and transwell assays; and immunofluorescence microscopy and flow cytometry. RESULTS: IFI30 was significantly upregulated in glioma tissues and cell lines compared with corresponding controls, and the expression level of IFI30 was positively associated with tumor grade. Functionally, both in vivo and in vitro evidence showed that IFI30 regulated the migration and invasion of glioma cells. Mechanistically, we found that IFI30 dramatically promoted the epithelial-mesenchymal transition (EMT)-like process by activating the EGFR/AKT/GSK3ß/ß-catenin pathway. In addition, IFI30 regulated the chemoresistance of glioma cells to temozolomide directly via the expression of the transcription factor Slug, a key regulator of the EMT-like process. CONCLUSION: The present study suggests that IFI30 is a regulator of the EMT-like phenotype and acts not only as a prognostic marker but also as a potential therapeutic target for temozolomide-resistant glioma.

Efficacy of minimally invasive tubular approaches for management of the lumbar spinal synovial cysts: a meta-analysis.

The treatment of lumbar spinal synovial cysts (LSCs) which are relatively rare but can cause neurogenic dysfunction and intractable pain has been a controversial topic for many years. Surgical excision of LSCs is the standard treatment for patients in whom conservative treatment options fail. This meta-analysis was undertaken to compare clinical outcomes between minimally invasive approaches using tubular retractors (microscopic vs. endoscopic) and traditional percutaneous approaches for LSCs. Studies reporting surgical management of LSCs were searched in the Cochrane Library, PubMed and Web of Science database. This meta-analysis was reported following the PRISMA Statement, registered in Prospero (CRD42021288992). A total of 1833 patients were included from both the related relevant studies (41 studies, n = 1831) and the present series (n = 2). Meta-analysis of minimally invasive tubular approaches revealed no statistically significant difference in pain improvement, dural tear, residual cyst, recurrence and operation time between minimal groups with traditional groups (p > 0.05). Minimal groups had better Functional improvement of 100% (95% CI 1.00-1.00; p < 0.001, I2 = 75.3%) and less reoperation rates of 0% (95% CI - 0.00-0.00; p = 0.007, I2 = 47.1%). Postoperative length of hospital stay and intraoperative bleeding in minimal groups were also less than traditional groups (p < 0.05). Subgroup analysis revealed endoscopic groups had less operation time (p = 0.004), and there was no significant difference in the rest. For patients with LSCs but without obvious clinical and imaging evidence of vertebral instability, even when preoperative stable grade 1 spondylolisthesis is present, minimally invasive tubular approaches without fusion may provide the best outcome in surgical management.