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Timing of decompression in central cord syndrome: a systematic review and meta-analysis

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Abstract

Purpose

This study compared the recovery of motor function and the safety of early and delayed surgical intervention in patients with central cord syndrome (CCS).

Methods

PubMed, Embase, Cochrane Library, and Web of Science were employed to retrieve the targeted studies published from inception to February 19, 2023. Comparative studies of early versus delayed surgical decompression in CCS based on American Spinal Injury Association motor score (AMS) recovery, complication rates, and mortality were selected. The statistical analyses were performed using STATA 16.0 and RevMan 5.4.

Results

Our meta-analysis included 13 studies comprising 8424 patients. Results revealed that early surgery improved AMS scores significantly compared with delayed surgery, with an increase in MDs by 7.22 points (95% CI 1.98–12.45; P = 0.007). Additionally, early surgery reduced the complication rates than delayed surgery (OR 0.53, 95% CI 0.42–0.67, P < 0.00001). However, no significant difference was observed in mortality between the two groups (OR 0.97; 95% CI 0.75–1.26; P = 0.84).

Conclusions

Early surgical decompression for CCS can improve motor function and reduce the incidence of complications without affecting the mortality rate in patients. Future research should focus on investigating and analyzing the optimal window period for early CCS surgery. Additionally, the timing of surgery should be determined based on the patient's condition and available medical resources.

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Acknowledgements

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Funding

Funding was provided by National Natural Science Foundation of the People’s Republic of China (Grant nos. 81973882, 81804119) and Beijing University of Chinese Medicine Science and Technology Innovation Project (Grant no. DZMKJCX-2023-010).

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Author notes

  1. Luchun Xu and Wenqing Zhong have contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, 100700, Beijing, People’s Republic of China

    Luchun Xu, Wenqing Zhong, Chen Liu, He Zhao, Yang Xiong, Shibo Zhou, Yukun Ma, Yongdong Yang & Xing Yu

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  1. Luchun Xu
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  2. Wenqing Zhong
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Correspondence to Yongdong Yang or Xing Yu.

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Xu, L., Zhong, W., Liu, C. et al. Timing of decompression in central cord syndrome: a systematic review and meta-analysis. Eur Spine J (2024). https://doi.org/10.1007/s00586-024-08244-3

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