Comparison of the Anterior and Posterior Approaches for the Management of Spinal Cord Injury: A Systematic Review

Abstract

Introduction: Spinal cord injury (SCI) is a devastating and disabling condition that predominantly affecting younger population. Several management protocols have been suggested to improve outcome of acute traumatic SCI including conservative and operative treatment. For the operative treatment, surgical decompression in SCI could be achieved by posterior, posterolateral and anterior approaches. This systematic review aim to compared the approaches in performing decompression in spinal cord injury. Methods: We conduct study from their inception dates to January 2021 with operative treatment of SCI with anterior and posterior approach as the inclusion criteria. Boolean method and PRISMA guideline was used to optimize the search and finding the study. All of the author assessed the quality of study. Results: A total of 4 studies were included in this systematic review. Three studies reported no significant difference between two approach while one study described anterior approach Is more effective than posterior approach. Discussion: There is still much debate about the approach to be used in patients with spinal cord injuries. Three studies mentioned neither the anterior approach nor the posterior approach had significant differences in managing SCI operatively. One study reported neurological recovery was found to be better in patients operated with the anterior approach. Conclusion: The effectiveness between the use of anterior and posterior approaches in patients with spinal cord injury that both had the same clinical outcome. The location of the difference is only in the posterior approach where there is a significant amount of blood loss also has a much longer hospital stay than the anterior approac Keywords: Spinal Cord Injury, SCI, Surgical Approach, Anterior Approaches, Posterior Approaches.