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

Background:The aim of this study was to investigate the efficacy of surgical treatment and conservative treatment for cervical spinal cord injury without fracture and dislocation (CSCIWFD) in adults by meta-analysis. Methods:With a time span from 2010 to 2022, PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI) and Wanfang databases were searched for all clinical randomized controlled trials on the comparison of surgical treatment and conservative treatment for CSCIWFD in adults. The Cochrane quality assessment tool was used as the standard. Stata 16.0 statistical software was used for meta-analysis. Results:A total of 870 articles were retrieved, and 12 studies were finally included for meta-analysis. Among them, there were 451 patients in the observation group (surgical treatment) and 346 patients in the control group (conservative treatment). The results of meta-analysis showed that the observation group was superior to the control group in the effective rate (OR = 4.737, 95% CI [2.613, 8.586], P < .001), Japanese Orthopedic Association (JOA) score at 3 months after treatment (SMD = 1.038, 95% CI [0.417, 1.659], P = .001), 6 months after treatment (SMD = 3.135, 95% CI [2.120, 4.151], P < .001) and 12 months after treatment (SMD = 2.808, 95% CI [1.880, 3.737], P < .001). In addition, the JOA scores of patients at 12 months after surgical treatment (SMD = 6.397, 95% CI [4.654, 8.14], P < .001) and conservative treatment (SMD = 3.197, 95% CI [2.144, 4.24], P < .001) were significantly higher than those before treatment. Conclusions:Surgical treatment can improve the effective rate and JOA score of adult patients with CSCIWFD compared to conservative treatment. This suggests that surgical treatment can significantly improve the patient's spinal cord function.