The benefits and harms of spinal fixation surgery for people with spinal cord injury due to trauma are not known at the moment

Bagnall A-M, Jones L, Duffy S, Riemsma RP

Published Online:

January 21, 2009

This review found no controlled trials of spinal fixation surgery for the patient group. The quality of the existing evidence is too poor to include in the review, as it is likely to be unreliable. Good quality controlled trials are needed to answer this question.

Abstract (click to read)

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.

This record should be cited as:

Bagnall A-M, Jones L, Duffy S, Riemsma RP. Spinal fixation surgery for acute traumatic spinal cord injury. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD004725. DOI: 10.1002/14651858.CD004725.pub2

Assessed as up to date:

October 10, 2007

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Primary Review Group:

Injuries Group

Health topics:

Neurology > Spinal cord injury

Orthopaedics & trauma > Spinal cord injury

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

The benefits and harms of spinal fixation surgery for people with spinal cord injury due to trauma are not known at the moment

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