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SYSTEMATIC REVIEW article

Front. Surg.
Sec. Neurosurgery
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1410220

Comparison Of Anterior And Posterior Approach In The Treatment Of Acute and Chronic Cervical Spinal Cord Injury: A Meta-Analysis

Provisionally accepted
Yi Ding Yi Ding 1Ning Li Ning Li 2Wenjing Hu Wenjing Hu 3Wenkang Jiang Wenkang Jiang 1Qianmiao Zhu Qianmiao Zhu 1Ting Jiang Ting Jiang 1Huilin Cheng Huilin Cheng 1,2*
  • 1 School of Medicine, Southeast University, Nanjing, Jiangsu Province, China
  • 2 Department of Neurosurgery, Zhongda Hospital, Southeast University, Bengbu, Liaoning Province, China
  • 3 School of Public Health, Southeast University, Nanjing, Jiangsu Province, China

The final, formatted version of the article will be published soon.

    A cervical spinal cord injury (CSCI) is a traumatic catastrophe that often leads to neurological dysfunction. The optimal surgical procedure for the treatment of CSCI remains debatable. The aim of this meta-analysis is to compare the neurological outcomes, complications, and clinical factors between anterior and posterior approach in CSCI treatment. We searched PubMed, Embase, Web of Science and Cochrane library from their inceptions to october 2023. Preoperative and postoperative Spinal Injury Association (ASIA) and Japanese Orthopedic Association (JOA) scores, and calculated recovery rates (RRs) were compared between the two strategies, and differences in complication rates, operation time, intraoperative blood loss and length of stay were also analyzed. A total of five studies containing 613 patients were included, with 320 patients undergoing the anterior approach and 293 patients undergoing the posterior approach. Four of the studies included were retrospective cohort studies of high quality as assessed by the Newcastle Ottawa Scale. Additionally, there was one randomized controlled trial evaluated with the Cochrane Risk of Bias tool. Although both anterior and posterior approaches effectively facilitate spinal decompression and promote good neurological recovery, there was no significant difference in the incidences of neurological dysfunction and complications or other clinical features between the two approaches. Hence, no evidence thus far supports one approach over the other. Large-scale randomized controlled studies are warranted to further distinguish these two methods.

    Keywords: Cervical spinal cord injury, outcomes, Anterior approach, Posterior approach, Meta-analysis

    Received: 25 May 2024; Accepted: 12 Aug 2024.

    Copyright: © 2024 Ding, Li, Hu, Jiang, Zhu, Jiang and Cheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Huilin Cheng, Department of Neurosurgery, Zhongda Hospital, Southeast University, Bengbu, Liaoning Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.