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Frontiers in neurology
2021;12 811873.

Effect of Twist-Drill Craniostomy With Hollow Screws for Evacuation of Chronic Subdural Hematoma: A Meta-Analysis.

Zeng Wei, Haixiao Jiang, Ying Wang, Cunzu Wang
Author Information
  1. Zeng Wei: Medical College of Yangzhou University, Yangzhou University, Yangzhou, China.
  2. Haixiao Jiang: Medical College of Yangzhou University, Yangzhou University, Yangzhou, China.
  3. Ying Wang: Medical College of Yangzhou University, Yangzhou University, Yangzhou, China.
  4. Cunzu Wang: Northern Jiangsu People's Hospital (NJPH), Yangzhou, China.
PMID: 35153988 DOI: 10.3389/fneur.2021.811873

Abstract

OBJECTIVE: This study systematically reviews the clinical efficacy and safety of twist-drill craniostomy with hollow screws in chronic subdural hematoma treatment.
METHODS: A computerized search of PubMed, Embase, Web of Science, Cochrane Library, World Health Organization International Trial Registry platform, CBM, CNKI, and Wanfang Database was performed to retrieve randomized controlled trials or case-control trials using twist-drill craniostomy (TDC) with hollow screws for the evacuation of chronic subdural hematoma from the date of databases' inception to July 2021. Two investigators independently screened the studies and extracted data in strict accordance with pre-established inclusion and exclusion criteria. RevMan 5.3 software or STATA was used for meta-analysis after evaluating the methodological quality of the included studies.
RESULTS: A total of 4 randomized controlled trials and 16 case-control trials with a total of 2,536 cases were included. Results of the meta-analysis showed that the surgical success rate and postoperative recurrence rate of TDC with hollow screws were slightly higher compared to the burr hole craniostomy (BHC) group, but showed no statistical significance (RR = 1.03, = 0.05; RR = 1.13, = 0.50). However, subgroup analysis showed that the use of YL-1 needle had a higher success rate and lower recurrence rate (RR = 1.05, = 0.02 < 0.05; RR = 0.584, = 0.002), and TDC with hollow screws had a lower incidence rate of postoperative complications and postoperative acute intracranial hemorrhage compared with BHC, also revealing an overall shorter hospital stay (RR = 0.57, = 0.0002 < 0.05; RR = 0.584, = 0.027 < 0.05; WMD = -3.752, < 0.001). However, the postoperative mortality rate was practically the same between the two groups (OR = 1.01, = 0.95 > 0.05).
CONCLUSION: Twist-drill craniostomy with hollow screws is not inferior or superior to BHC in efficacy, and this strategy is safer and minimally invasive, which is reflected in a lower incidence of acute intracranial hemorrhage, overall complication rate, and length of hospital stay.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021270835.

Keywords

SEPs YL-1 needle chronic subdural hematoma meta-analysis the hollow screw

References

  1. Neurosurg Clin N Am. 2017 Apr;28(2):205-210 [PMID: 28325454]
  2. J Neurosurg Sci. 2005 Jun;49(2):41-6; discussion 46-7 [PMID: 16247343]
  3. No Shinkei Geka. 2011 Dec;39(12):1149-53 [PMID: 22128269]
  4. Exp Ther Med. 2018 Aug;16(2):959-965 [PMID: 30116345]
  5. J Neurosurg. 2013 Mar;118(3):694-700 [PMID: 23259822]
  6. Neurohospitalist. 2020 Oct;10(4):257-265 [PMID: 32983343]
  7. Acta Neurochir (Wien). 1975;32(3-4):247-50 [PMID: 1225014]
  8. J Neurosurg. 2014 Jul;121(1):176-83 [PMID: 24785319]
  9. World Neurosurg. 2016 Feb;86:399-418 [PMID: 26485412]
  10. Medicine (Baltimore). 2016 Mar;95(10):e3036 [PMID: 26962823]
  11. Acta Neurochir (Wien). 2007;149(5):487-93; discussion 493 [PMID: 17387427]
  12. Neurol Res. 2013 Apr;35(3):233-42 [PMID: 23485050]
  13. J Neurosurg. 2010 Sep;113(3):609-14 [PMID: 20001585]
  14. Wideochir Inne Tech Maloinwazyjne. 2019 Sep;14(3):442-450 [PMID: 31534576]
  15. Curr Treat Options Neurol. 2018 Jul 18;20(8):34 [PMID: 30019165]
  16. J Neurosurg. 2017 Dec;127(6):1443-1448 [PMID: 28106501]
  17. Nat Rev Neurol. 2014 Oct;10(10):570-8 [PMID: 25224156]
  18. Turk Neurosurg. 2017;27(1):60-65 [PMID: 27593747]
  19. J Neurosurg. 2009 Dec;111(6):1257-62 [PMID: 19558304]
  20. Neurol Med Chir (Tokyo). 1992 Apr;32(4):207-9 [PMID: 1378564]
  21. J Neurol Neurosurg Psychiatry. 2003 Jul;74(7):937-43 [PMID: 12810784]
  22. J Craniofac Surg. 2018 Jan;29(1):e90-e94 [PMID: 29194262]
  23. J R Soc Med. 2002 Jun;95(6):290-2 [PMID: 12042376]
  24. J Craniofac Surg. 2017 May;28(3):646-649 [PMID: 28468141]
  25. Acta Neurol Belg. 2020 Feb;120(1):37-42 [PMID: 29623601]
  26. J Clin Neurosci. 2018 Apr;50:7-15 [PMID: 29428263]
  27. World Neurosurg. 2020 Jul;139:e355-e362 [PMID: 32305600]
  28. J Neurosurg. 2010 Sep;113(3):615-21 [PMID: 19877806]
  29. J Neurosurg. 2015 Nov;123(5):1209-15 [PMID: 25794342]
  30. Acta Neurochir (Wien). 1997;139(9):818-25, discussion 825-6 [PMID: 9351986]
  31. J Clin Neurosci. 2021 Apr;86:154-163 [PMID: 33775320]
Systematic Review Journal Article
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