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Spinal fixation surgery for acute traumatic spinal cord injury
A M Bagnall1, L Jones, S Duffy
1Leeds Metropolitan University, School of Health & Community Care, Calverley Street, Leeds, UK LS1 3HE. A.Bagnall@leedsmet.ac.uk
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.
