Journals / Acta Orthopaedica et Traumatologica Turcica / 2018 / Cilt: 52 - Sayı: 2

Early surgical decompression within 8 hours for traumatic spinal cord injury: Is it beneŞcial? A meta-analysis

Pages
101–108
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Early surgical decompression (within 8 h) is recommended forpatients with tSCI.Level of evidence: Level III, therapeutic study.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Introduction: The aim of this study is to evaluate whether early (<8 h) surgical decompression is better inimproving 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 May2016 that compared the outcomes of early versus late surgery for tSCI.
📊
Key Findings & Data:Theresults are presented as relative ratio (RR) for binary outcomes and mean difference (MD) for continuousoutcomes with 95% conŞdence intervals (CIs).Results: Seven studies wereŞnally included in this meta-analysis.
💡
Conclusion & Impact:Early surgical decompression (within 8 h) is recommended forpatients with tSCI.Level of evidence: Level III, therapeutic study.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Introduction: The aim of this study is to evaluate whether early (<8 h) surgical decompression is better inimproving 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 May2016 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. Theresults are presented as relative ratio (RR) for binary outcomes and mean difference (MD) for continuousoutcomes with 95% conŞdence intervals (CIs).Results: Seven studies wereŞnally included in this meta-analysis. There were signiŞcant differencesbetween the 2 groups in neurologic improvement (MD¼ 0.54, 95% CI ¼ 18.52 to 7.02, P < 0.0001) andlength of hospital stay (MD¼ 12.77, 95% CI ¼ 0.34e0.74, P < 0.00001). However, no signiŞcant differences were found between the 2 groups in perioperative complications (OR¼ 0.95, 95% CI ¼ 0.35e2.61, P ¼ 0.92).Conclusions: Early surgical decompression within 8 h after tSCI was beneŞcial in terms of neurologicimprovement compared with late surgery. Early surgical decompression (within 8 h) is recommended forpatients with tSCI.Level of evidence: Level III, therapeutic study.

🔖

Cite This Article

HWANG, S. B., KİM, *. D. B., AHN, H. C., KİM, H. C., PARK, Y. B., LEE, D. A. (2018). Early surgical decompression within 8 hours for traumatic spinal cord injury: Is it beneŞcial? A meta-analysis. Acta Orthopaedica et Traumatologica Turcica, Cilt: 52 - Sayı: 2, 101–108. https://ajindex.com/articles/353503

References (12)

  1. Wyndaele M, Wyndaele JJ. Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey? Spinal Cord. 2006;44(9):523e529
  2. Bracken MB, Shepard MJ, Collins WF, et al. A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. results of the second national acute spinal cord injury study. N Engl J Med. 1990;322(20):1405e1411
  3. Bracken MB, Shepard MJ, Holford TR, et al. Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. results of the third national acute spinal cord injury randomized controlled trial. National acute spinal cord injury study. JAMA. 1997;277(20):1597e1604
  4. Amar AP, Levy ML. Pathogenesis and pharmacological strategies for mitigating secondary damage in acute spinal cord injury. Neurosurgery. 1999;44(5): 1027e1039
  5. Liu JM, Long XH, Zhou Y, Peng HW, Liu ZL, Huang SH. Is urgent decompression superior to delayed surgery for traumatic spinal cord Injury? A meta-analysis. World Neurosurg. 2016;87:124e131
  6. Fehlings MG, Vaccaro A, Wilson JR, et al. Early versus delayed decompression for traumatic cervical spinal cord injury: results of the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS). PLoS One. 2012;7(2):e32037
  7. Cengiz SL, Kalkan E, Bayir A, Ilik K, Basefer A. Timing of thoracolomber spine stabilization in trauma patients; impact on neurological outcome and clinical course. a real prospective (rct) randomized controlled study. Arch Orthop Trauma Surg. 2008;128(9):959e966
  8. Chen Qi, Li Feng, Fang Zhong, et al. Timing of surgical decompression for acute traumatic cervical spinal cord injury: a multicenter study. Neurosurg Q. 2012;22:61e68
  9. McCarthy MJ, Gatehouse S, Steel M, Goss B, Williams R. The influence of the energy of trauma, the timing of decompression, and the impact of grade of SCI on outcome. Evid Base Spine Care J. 2011;2(2):11e17
  10. Gaebler C, Maier R, Kutscha-Lissberg F, Mrkonjic L, Vecsei V. Results of spinal cord decompression and thoracolumbar pedicle stabilisation in relation to the time of operation. Spinal Cord. 1999;37(1):33e39
  11. Grassner L, Wutte C, Klein B, et al. Early decompression (_____8 h) after traumatic cervical spinal cord injury improves functional outcome as assessed by spinal cord independence measure after one year. J Neurotrauma. 2016;33(18): 1658e1666
  12. Jug M, Kejzar N, Vesel M, et al. Neurologica