Surgery for degenerative lumbar spondylosis
Abstract Background Surgical investigations and interventions account for large health care utilisation and costs, but the scientific evidence for most procedures is still limited. Objectives Degenerative conditions affecting the lumbar spine are variously described as lumbar spondylosis or degenerative disc disease (which we regarded as one entity) and may be associated with back pain and […]
Gangliosides for acute spinal cord injury
Abstract Background Spinal cord injury (SCI) results in loss of feeling and movement. The consequences can be devastating for the patient and his or her carers. Global estimates of the number of new cases annually range from 15 to 40 per million. Leading causes of acute SCI are road traffic injury, violence, and injuries sustained […]
Percutaneous transluminal angioplasty and stenting for vertebral artery stenosis
Abstract Background Surgery for vertebral artery stenosis is technically difficult, potentially hazardous and is not considered in most centres. There is growing evidence from case series that vertebral artery stenosis may be treated endovascularly by percutaneous transluminal angioplasty and stenting. This may be a feasible alternative to surgery to relieve symptoms caused by significant stenosis. […]
Calcium channel blockers for acute traumatic brain injury
Abstract Background Acute traumatic brain injury is a major cause of death and disability. Calcium channel blockers (calcium antagonists) have been used in an attempt to prevent cerebral vasospasm after injury, maintain blood flow to the brain, and so prevent further damage. Objectives To estimate the effects of calcium channel blockers in patients with acute […]
Chemotherapy for high-grade glioma
Abstract Background Trials on the effect of systemic chemotherapy on survival and recurrence in adults with high-grade glioma have had inconclusive results. We undertook a systematic review and meta-analysis to assess the effects of such treatment on survival and recurrence. Objectives To compare radiotherapy plus chemotherapy with radiotherapy alone in completely resected adults with high-grade […]
Excitatory amino acid inhibitors for traumatic brain injury
Abstract Background Glutamate is the principal excitatory neurotransmitter in the brain. Injury to the brain can cause an ionic imbalance in cerebral tissue, creating an excitotoxic cascade involving glutamate and other excitatory amino acids, that leads to neuronal death in the tissue surrounding the original injury site. Research has centred around inhibiting this increase in […]
Eversion versus conventional carotid endarterectomy for preventing stroke
Abstract Background Carotid endarterectomy (CEA) is conventionally undertaken by a longitudinal arteriotomy. Eversion CEA, which employs a transverse arteriotomy and reimplantation of the carotid artery, is reported to be associated with low perioperative stroke and restenosis rates but an increased risk of complications associated with a distal intimal flap. Objectives To determine whether eversion CEA […]
Hyperventilation therapy in acute traumatic brain injury
Abstract Background Because hyperventilation is often associated with a rapid fall in intracranial pressure, it has been assumed to be effective in the treatment of severe head injury. Hyperventilation reduces raised intracranial pressure by causing cerebral vasoconstriction and a reduction in cerebral blood flow. Whether or not reduced cerebral blood flow improves neurological outcome is, […]