Effect of surgical intervention time on the recovery of nerve function in acute spinal cord injury: a Meta-analysis

Abstract

To evaluate the efficacy and safety of different operation time for acute spinal cord injury(SCI) based on systematic review. PubMed database, EMBASE database, Cochrane Library, ISI Web of knowledge, CBM database, VIP database, CNKI database and Wanfang database were searched from their start year up to February 2017 for relevant randomized clinical trials on the treatment of acute spinal cord injury with different intervention times. Four randomized clinical trials of total 156 cases were included. Early surgical intervention for the patients with incomplete spinal cord injury can improve the ASIA motor function score [MD=3.29, 95%CI(-7.90, 14.49), P=0.56] and overall Frankel score[OR=7.65, 95%CI(2.69, 21.74), P=0.000 1]. There was no significant difference in the improvement of the overall Frankel score[OR=4.88, 95%CI(0.74, 32.09), P=0.10] for the patients with complete spinal cord injury between the early surgery and delayed surgery group. There was no significant difference in hospitalization time[MD=-3.4, 95%CI(-8.12, 1.32), P=0.16], death rate [OR=1.07, 95%CI(0.21, 5.56), P=0.93]and incidence of decubitus[OR=1.07, 95%CI(0.17, 6.69), P=0.94] between the early surgery and delayed surgery group. Early surgical intervention can promote the nerve function recovery after spinal cord injury, whithout further incidence of complications, but random control trails with higher quality are still required for this conclusion.