Efficacy of surgical treatment and conservative treatment for cervical spinal cord injury without fracture and dislocation in adults: A meta-analysis

This study investigates the best treatment approach for adults with cervical spinal cord injury without fracture or dislocation (CSCIWFD), comparing surgical and conservative methods. CSCIWFD involves spinal cord dysfunction after trauma, visible on MRI as spinal cord compression and soft tissue injury, but without vertebral fractures or dislocations. Researchers analyzed multiple randomized controlled trials (RCTs) to determine if surgery or conservative treatment is more effective for CSCIWFD. The analysis focused on outcomes like effective treatment rates and Japanese Orthopedic Association (JOA) scores, which assess motor function. The study found that surgery is generally more effective than conservative treatment for improving treatment success rates and JOA scores at various intervals post-treatment. Both surgical and conservative approaches showed improvement over pre-treatment scores, but surgical intervention led to more significant gains.

• 1
  Surgical treatment showed a significantly higher effective rate compared to conservative treatment (OR = 4.737, P < .001).
• 2
  Patients undergoing surgical treatment exhibited superior JOA scores at 3 months (SMD = 1.038, P = .001), 6 months (SMD = 3.135, P < .001) and 12 months (SMD = 2.808, P < .001) after treatment compared to those undergoing conservative treatment.
• 3
  Both surgical and conservative treatments significantly improved JOA scores 12 months post-treatment compared to pre-treatment scores (P < .001).