Although both long and short cephalomedullary devices (CMDs) are used in the treatment of extracapsular hip fractures, the advantages of either option are subject to debate. This study aims to evaluate the differences in clinical outcomes with long versus short CMDs for extracapsular hip fractures. Studies included must have included subjects with at least 1 year of follow-up and reported on at least one of the following outcomes: rate of reoperation; rate of peri-implant fracture; operating time; blood loss; complication rate; length of hospital stay; 1-year mortality. Only articles written in the English language were included in this study. A search was conducted across the databases of Medline, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL and Scopus for articles published from the inception of the database to 1 November 2020. Included studies were assessed for their risk of bias using the Risk of Bias Tool (RoB2) and the risk-of-bias in non-randomized studies – of interventions (ROBINS-I) tool. A total of 8460 fractures from 16 studies were included in the analysis, with 3690 fixed with short, and 4770 fixed with long CMDs. A meta-analysis of the results revealed that short CMDs offer peri-operative advantages, while long CMDs could offer longer-term advantages. Limitations of this study include a lack of randomized control trials included in the analysis. In conclusion, when planning for the treatment of extracapsular hip fractures, a patient specific approach may be necessary to make a decision according to the individual risk profile of the patient.
Objective: To ascertain the accuracy of 2 upper-arm blood pressure monitors, GE Carescape V100 Vital Signs and Omron HEM-9210T, used in a large, South-East Asian epidemiological cohort by the AAMI/ESH/ISO 81060-2:2018. Methods: 149 participants were recruited from the ongoing Health for Life in Singapore (HELIOS) Study in multi-ethnic Singapore. Results: 110 datasets were analysed. For criterion 1, the mean(SD) of differences for GE Carescape V100 was -3.5(7.4)/ -3.5(7.4) mmHg (systolic/diastolic), and -4.2(6.9)/ -4.2(6.9) mmHg (systolic/diastolic) for Omron HEM-9210T. For criterion 2, GE Carescape V100was -3.5(5.6) / -3.5(5.6) mmHg (systolic/diastolic), and -4.2(4.5) / -4.2(4.6) mmHg (systolic/diastolic) for Omron HEM-9210T. Conclusion: Both GE Carescape V100 Vital Signs and Omron HEM-9210T monitor passed the AAMI/ESH/ISO 81060-2:2018 validation standard.
Study design Retrospective Cohort Study Objectives To compare early postoperative radiological and clinical outcomes between 2-level minimally invasive (MIS) trans-psoas lateral lumbar interbody fusion (LLIF) and MIS transforaminal lumbar interbody fusion (TLIF) for degenerative lumbar spinal stenosis. Methods Fifty three consecutive patients undergoing 2-level lumbar interbody fusion from L3-L5 for degenerative lumbar spinal stenosis were enrolled. Twenty four patients underwent LLIF and 29 underwent TLIF. Results Operative time and length of stay were similar between LLIF and TLIF (272.8 ± 82.4 vs 256.1 ± 59.4 minutes; 5.5 ± 2.8 vs 4.7 ± 3.3 days, P > .05), whereas blood loss was lower for LLIF (229.0 ± 125.6 vs 302.4 ± 97.1mls, P = .026). Neurological deficits were more common in LLIF (9 vs 3, P = .025), whereas persistent deficits were rare for both (1 vs 1, P = 1). For both groups, all patient reported outcomes visual analogue scale (VAS back pain, VAS leg pain, ODI, SF-36 physical) improved from preoperative to 2-years postoperative ( P < .05), with both groups showing no significant differences in extent of improvement for any outcome. Lateral lumbar interbody fusion demonstrated superior restoration of disc height (L3-L4: 4.1 ± 2.4 vs 1.2 ± 1.9 mm, P < .001; L4-L5: 4.6 ± 2.4 vs .8 ± 2.8 mm, P < .001), foraminal height (FH) (L3-L4: 3.5 ± 3.6 vs 1.0 ± 3.6 mm, P = .014; L4-L5: 3.0 ± 3.5 vs -.1 ± 4.4 mm, P = .0080), segmental lordosis (4.1 ± 6.4 vs -2.1 ± 8.1°, P = .005), lumbar lordosis (LL) (4.1 ± 7.0 vs -2.3 ± 12.6°, P = .026) and pelvic incidence-lumbar lordosis (PI-LL) mismatch (−4.1 ± 7.0 vs 2.3 ± 12.6°, P = .019) at 2-years follow-up. Conclusion The superior radiological outcomes demonstrated by 2-level trans-psoas LLIF did not translate into difference in clinical outcomes compared to 2-level TLIF at the 2-years follow-up, suggesting both approaches are reasonable for 2-level lumbar interbody fusion in degenerative lumbar spinal stenosis.
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