Evaluation of full-endoscopic lumbar discectomy in the treatment of obese adolescents with lumbar disc herniation: a retrospective study.

BACKGROUND: Obese patients are at risk of complications after spinal surgery. Full-endoscopic lumbar discectomy (FELD) has advantages over conventional open surgery in the treatment of obese adult patients with lumbar disc herniation (LDH) because it can decrease perioperative complications and enhance the degree of patient satisfaction. However, no clinical studies have evaluated the efficacy of FELD in obese adolescents with LDH (ALDH). This study aimed to evaluate the efficacy of FELD for the treatment of obese ALDH. METHODS: We retrospectively collected clinical data from 208 patients with single-segment ALDH who underwent FELD in our hospital between January 2015 and December 2019. According to the WHO classification of obesity, the patients were divided into obese (BMI ≥30 kg/m2) and non-obese (BMI < 30 kg/m2) groups (control group). Based on the preoperative baseline data of the two groups, propensity score matching was performed to select patients from these groups for a comparative study. Perioperative data included operative time, intraoperative blood loss, and length of postoperative hospitalization. The visual analog scale (VAS), Oswestry disability index (ODI), and modified MacNab criteria were recorded as the main indicators of the surgical outcome. Recurrence rate and incidence of complications were recorded as minor indicators. RESULTS: Twenty-eight patients and 80 patients were included in the obese and non-obese groups, respectively, after 1:4 propensity score matching. Both groups showed improvements in VAS and ODI scores after surgery and at each follow-up time point (p < 0.05). However, there was no significant statistical difference in the surgical outcomes between the two groups at each follow-up time point (p > 0.05). The differences in operative time, intraoperative blood loss, and length of postoperative hospitalization were not statistically significant between the two groups (p > 0.05). CONCLUSION: FELD is a safe and effective minimally invasive technique for treating obese patients with ALDH. The efficacy of FELD in obese and non-obese patients with ALDH was comparable.

Comparison of Percutaneous Endoscopic Lumbar Discectomy and Open Lumbar Discectomy in the Treatment of Adolescent Lumbar Disc Herniation: A Retrospective Analysis.

OBJECTIVE: To compare and analyze efficacy and safety of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar discectomy (OLD) for adolescent lumbar disc herniation. METHODS: Clinical data of 257 patients with single-segment adolescent lumbar disc herniation who underwent surgical treatment from January 2015 to December 2019 were retrospectively collected. The patients were divided into PELD and OLD groups based on the surgical method used. Propensity score matching was performed using preoperative baseline data of patients in both groups, and some patients in both groups were selected for comparative study. Clinical and follow-up data were assessed and compared. RESULTS: There was no statistically significant difference in preoperative baseline data between the 2 groups of patients after propensity score matching. Visual analog scale and Oswestry Disability Index scores improved in both groups postoperatively and at each follow-up time point (P < 0.05). However, visual analog scale scores on the first postoperative day and Oswestry Disability Index scores at 3 months postoperatively were lower in the PELD group than in the OLD group (P < 0.05). Duration of surgery, intraoperative blood loss, and duration of postoperative hospitalization were lower in the PELD group than in the OLD group (P < 0.05). There was no statistically significant difference between the 2 groups when comparing complication and recurrence rates (P >0.05). CONCLUSIONS: Both PELD and OLD are effective and safe surgical techniques for treatment of adolescent lumbar disc herniation. However, compared with OLD, PELD is more advantageous for rapid symptom relief and improving postoperative quality of life with a low rate of complications and recurrence.

Efficacy of mometasone furoate for nasal polyps: A protocol for systematic review of randomized controlled trial.

BACKGROUND: This study aims to systematically explore the efficacy and safety of mometasone furoate (MTF) for patients with nasal polyps (NP). METHODS: We will search MEDLINE, Cochrane Library, PubMed, Springer, Web of Science, Ovid, Wangfang and Chinese Biomedical Literature Database from their inception to April 30, 2019 without language restrictions. All randomized controlled trials (RCTs) of MTF for the treatment of NP will be considered for inclusion. RevMan 5.3 software will be used for data synthesis, subgroup analysis, sensitivity analysis, as well as the meta-analysis. RESULTS: Primary outcomes include change in symptom scores (as measured by any symptom scores), and polyp size (as assessed by any Polyp size scores or tools). Secondary outcomes consist of polyp recurrence, change in nasal air flow, quality of life outcomes (as measured by any quality of life scales, such as Short Form Health Survey is a 36-item), and adverse events. CONCLUSION: This study will provide evidence for judging whether MTF is an effective and safe treatment for NP or not. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019134037.

Acupuncture for hearing loss after traumatic brain injury: A protocol for systematic review of randomized controlled trial.

BACKGROUND: This study aims to systematically assess the effectiveness and safety of acupuncture on hearing loss (HL) after traumatic brain injury (TBI). METHODS: In this study, the following databases will be retrieved from inception up to the May 1, 2019: PUBMED, EMBASE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, and Chinese Biomedical Literature Database. All databases will be retrieved without any language restrictions. Two reviewers will independently carry out article selection, data collection, and risk of bias evaluation. Any disagreements will be solved by a third reviewer through discussion. RESULTS: This study will systematically investigate the effectiveness and safety of acupuncture for treating HL after TBI through evaluating HL assessment, hearing threshold, quality of life, and adverse events. CONCLUSION: The expected findings of this study will provide latest evidence for assessing the effectiveness and safety of acupuncture for HL after TBI. ETHICS AND DISSEMINATION: This study is supposed to be published in a peer-reviewed journal. No ethical approval is needed because this study will based on the literature analysis, but not the individual patient. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019133417.