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

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.