关键词: 无骨折脱位型颈脊髓损伤, 手术治疗, 非手术治疗, Meta分析

Abstract: Objective To systematically assess the clinical efficacy of surgical treatment versus conservative treatment for CSCIWFD from previously clinical investigations. Methods A systematic search of all the studies published was conducted on the PubMed, Cochrane Library, EMbase, OVID, CNKI, VIP and Wanfang databases. Randomized and non-randomized controlled trials that compared between surgical treatment and conservative treatment for CSCIWFD were identified. Two reviewers independently screened the literature according to the inclusive and exclusive criteria, extracted the data, and assessed the quality of included studies. Meta-analyses were performed to assess variables including Japanese Orthopaedic Association scores(JOA), Neurological function recovery rate, ASIA impairment scale grade, ASIA motor scores. Results ①A total of 13 articles were included, involving 598 patients, of which 371 and 227 patients received sugical or conservative treatment. ②The results of the meta-analysis indicated that, compared with conservative group, surgical group has higher JOA scores[MD=3.08,95%CI(2.71,3.45),Z=16.29,P<0.000 01], better Neurological function recovery rate[MD=15.87,95%CI(9.28,22.46),Z=4.72,P<0.000 01], better ASIA impairment scale grade improvement[OR=2.3,95%CI(1.25,4.15),Z=2.76,P=0.006], and there were no significant differences in the ASIA motor scores[MD=5.45,95%CI(-7.56,18.47),Z=0.82,P=0.41]. Conclusion These result suggests that surgical treatment can improve the neurological function more effectively for patients with cervical spinal cord injury without fracture and dislocation.

Key words: Cervical spinal cord injury without fracture and dislocation, Surgical treatment, Conservative treatment, Meta-Analysis