Meta-analysis of pre-clinical studies of early decompression in acute spinal cord injury: a battle of time and pressure

The use of early decompression in the management of acute spinal cord injury (SCI) remains contentious despite many pre-clinical studies demonstrating benefits and a small number of supportive clinical studies. Although the pre-clinical literature favours the concept of early decompression, translat...

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Bibliographic Details
Published in:PloS one 2013-08, Vol.8 (8), p.e72659-e72659
Main Authors: Batchelor, Peter E, Wills, Taryn E, Skeers, Peta, Battistuzzo, Camila R, Macleod, Malcolm R, Howells, David W, Sena, Emily S
Format: Article
Language:English
Subjects:
Animal models
Animals
Bias
Compression
Decompression
Decompression, Surgical
Disease Models, Animal
Effectiveness
Experiments
Injuries
Medical ethics
Medical research
Medicine
Mental health
Meta-analysis
Neurosciences
NMR
Nuclear magnetic resonance
Paralysis
Paraplegia
Paresis
Pressure
Pressure effects
Publication Bias
Regression analysis
Spinal cord injuries
Spinal Cord Injuries - pathology
Spinal Cord Injuries - physiopathology
Spinal Cord Injuries - surgery
Stroke
Studies
Systematic review
Time Factors
Trauma
Treatment Outcome
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Summary:The use of early decompression in the management of acute spinal cord injury (SCI) remains contentious despite many pre-clinical studies demonstrating benefits and a small number of supportive clinical studies. Although the pre-clinical literature favours the concept of early decompression, translation is hindered by uncertainties regarding overall treatment efficacy and timing of decompression. We performed meta-analysis to examine the pre-clinical literature on acute decompression of the injured spinal cord. Three databases were utilised; PubMed, ISI Web of Science and Embase. Our inclusion criteria consisted of (i) the reporting of efficacy of decompression at various time intervals (ii) number of animals and (iii) the mean outcome and variance in each group. Random effects meta-analysis was used and the impact of study design characteristics assessed with meta-regression. Overall, decompression improved behavioural outcome by 35.1% (95%CI 27.4-42.8; I(2)=94%, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0072659