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Cochrane Database Syst Rev. 2008 Jan 23;(1):CD004725. doi: 10.1002/14651858.CD004725.pub2.

Spinal fixation surgery for acute traumatic spinal cord injury.

Author information

1
Leeds Metropolitan University, School of Health & Community Care, Calverley Street, Leeds, UK LS1 3HE. A.Bagnall@leedsmet.ac.uk

Abstract

BACKGROUND:

If the spine is unstable following traumatic spinal cord injury (SCI), surgical fusion and bracing may be necessary to obtain vertical stability and prevent re-injury of the spinal cord from repeated movement of the unstable bony elements. It has been suggested that this spinal fixation surgery may promote early rehabilitation and mobilisation.

OBJECTIVES:

To answer the question: is there a difference in functional outcome and other commonly measured outcomes between people who have a spinal cord injury and have had spinal fixation surgery and those who have not?

SEARCH STRATEGY:

The following databases were searched: AMED, CCTR, CINAHL, DARE, EMBASE, HEED, HMIC, MEDLINE, NRR, NHS EED. Searches were updated in May 2003 and MEDLINE was searched again in May 2007. The reference lists of retrieved articles were checked.

SELECTION CRITERIA:

Randomised controlled trials and controlled trials that compared surgical spinal fixation, with or without decompression, to any other treatment, in patients with a traumatic SCI.

DATA COLLECTION AND ANALYSIS:

Two reviewers independently selected studies. One reviewer assessed the quality of the studies and extracted data.

MAIN RESULTS:

No randomised controlled trials or controlled trials were identified that compared surgical spinal fixation surgery to other treatments in patients with a traumatic SCI. All of the studies identified were retrospective observational studies and of poor quality.

AUTHORS' CONCLUSIONS:

The current evidence does not enable conclusions to be drawn about the benefits or harms of spinal fixation surgery in patients with traumatic SCI. Well-designed, prospective experimental studies with appropriately matched controls are needed.

PMID:
18254059
DOI:
10.1002/14651858.CD004725.pub2
[Indexed for MEDLINE]

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