TY - JOUR
T1 - Early surgical decompression within 8 hours for traumatic spinal cord injury
T2 - Is it beneficial? A meta-analysis
AU - Lee, Dong Yeong
AU - Park, Young Jin
AU - Kim, Hyun Jung
AU - Ahn, Hyeong Sik
AU - Hwang, Sun Chul
AU - Kim, Dong Hee
N1 - Publisher Copyright:
© 2017 Turkish Association of Orthopaedics and Traumatology
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/3
Y1 - 2018/3
N2 - Introduction: The aim of this study is to evaluate whether early (<8 h) surgical decompression is better in improving neurologic outcomes than late (≥8 h) surgical decompression for traumatic spinal cord injury (tSCI). Methods: The various electronic databases were used to detect relevant articles published up until May 2016 that compared the outcomes of early versus late surgery for tSCI. Data searching, extraction, analysis, and quality assessment were performed according to Cochrane Collaboration guidelines. The results are presented as relative ratio (RR) for binary outcomes and mean difference (MD) for continuous outcomes with 95% confidence intervals (CIs). Results: Seven studies were finally included in this meta-analysis. There were significant differences between the 2 groups in neurologic improvement (MD = 0.54, 95% CI = −18.52 to −7.02, P < 0.0001) and length of hospital stay (MD = −12.77, 95% CI = 0.34–0.74, P < 0.00001). However, no significant differences were found between the 2 groups in perioperative complications (OR = 0.95, 95% CI = 0.35–2.61, P = 0.92). Conclusions: Early surgical decompression within 8 h after tSCI was beneficial in terms of neurologic improvement compared with late surgery. Early surgical decompression (within 8 h) is recommended for patients with tSCI. Level of evidence: Level III, therapeutic study.
AB - Introduction: The aim of this study is to evaluate whether early (<8 h) surgical decompression is better in improving neurologic outcomes than late (≥8 h) surgical decompression for traumatic spinal cord injury (tSCI). Methods: The various electronic databases were used to detect relevant articles published up until May 2016 that compared the outcomes of early versus late surgery for tSCI. Data searching, extraction, analysis, and quality assessment were performed according to Cochrane Collaboration guidelines. The results are presented as relative ratio (RR) for binary outcomes and mean difference (MD) for continuous outcomes with 95% confidence intervals (CIs). Results: Seven studies were finally included in this meta-analysis. There were significant differences between the 2 groups in neurologic improvement (MD = 0.54, 95% CI = −18.52 to −7.02, P < 0.0001) and length of hospital stay (MD = −12.77, 95% CI = 0.34–0.74, P < 0.00001). However, no significant differences were found between the 2 groups in perioperative complications (OR = 0.95, 95% CI = 0.35–2.61, P = 0.92). Conclusions: Early surgical decompression within 8 h after tSCI was beneficial in terms of neurologic improvement compared with late surgery. Early surgical decompression (within 8 h) is recommended for patients with tSCI. Level of evidence: Level III, therapeutic study.
KW - Decompression
KW - Meta-analysis
KW - Spinal cord injuries
KW - Timing of surgery
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U2 - 10.1016/j.aott.2017.12.001
DO - 10.1016/j.aott.2017.12.001
M3 - Article
C2 - 29289419
AN - SCOPUS:85044653823
VL - 52
SP - 101
EP - 108
JO - Acta Orthopaedica et Traumatologica Turcica
JF - Acta Orthopaedica et Traumatologica Turcica
SN - 1017-995X
IS - 2
ER -