Cervical Anterior And Posterior Surgical Treatment Of Spinal Cord Injury Without Fracture And Dislocation Effectiveness And Related Date:A Meta-analysis

AIMS:A meta-analysis was performed to compare the surgical outcomes and related date between anterior and posterior in the treatment for cervical spinal cord injury without fracture and dislocation,and to provide some theoretical basis for making clinical decision.METHOD:Search the electronic domestic and foreign database from January 2010 to November 2018.Through the index,the full text and original data were obtained.According the inclusion and exclusion,choose the appropriate literature for further select.Use NOS scale to assess the quality of literature.Extract the data and use Review manager 5.3 to proceed the meta analysis.According to the results of the analysis,we can draw a conclusion that can be used for clinical reference.RESULT:This study included 10 retrospective literatures.Containing 389 patients were included in our study.There were significant difference between two groups,the operation time(MD=-41.98,95%CI=-48.73~-35.22,P < 0.05)? blood loss(MD=-104.05,95%CI=-114.05~-94.05,P<0.05)and complication rate(RR=0.42,95%CI=0.20~0.87,P<0.05).The anterior surgery group has the lower blood loss and less operation time and complication rate.The analysis showed that there were no significant difference in JOA score before the surgery(MD=0.22,95%CI=-0.06~0.49,P=0.12)?JOA score post the surgery(MD=0.06,95%CI=-0.50~0.62,P=0.84)? neurological improvement rate(MD=-0.21,95%CI=-1.67~1.22,P=0.78)? neck disability index(MD=-0.66,95%CI=-3.10~1.78,P=0.60)?the MOS item(MD=-2.23,95%CI=-5.53~1.07,P=0.18)? ASIA motor score(MD=0.68,95%CI=-0.58~1.94,P=0.29).CONCLUSION:Based on our meta-analysis,except for blood loss,the operation time and complication rate,anterior and posterior surgical treatment were no significant difference in JOA score,neurological improvement rate,neck disability index,the MOS survey,ASIA motor score.Both anterior and posterior surgery are effective options for the treatment of cervical spinal cord injury without fracture and dislocation.