ReviewCureus2025
Effect of Early Surgical Intervention on Neurological Outcomes in Acute Spinal Cord Injury: A Systematic Review and Meta-Analysis.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Spinal cord injury (SCI) represents a devastating condition with profound neurological consequences, and the optimal timing of surgical decompression remains controversial. This systematic review and meta-analysis evaluated the impact of early versus late surgical intervention on neurological outcomes and mortality in patients with SCI. A comprehensive literature search was conducted across multiple databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Scopus, from 2000 to September 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies comparing early surgical decompression (≤24 h) with delayed intervention (>24 h) in adult patients were included. Fourteen studies comprising 2,505 patients (1,115 early intervention, 1,390 delayed intervention) met the inclusion criteria, including three randomized controlled trials (RCTs) and 11 observational studies. The pooled analysis demonstrated a non-significant trend toward improved neurological recovery with early intervention, evidenced by a mean difference (MD) of 3.64 points in the American Spinal Injury Association (ASIA) Motor Score (AMS; 95% CI: -0.05 to 7.33; p = 0.05) and an OR of 1.37 for achieving at least one-grade improvement in ASIA classification (95% CI: 0.90 to 2.10; p = 0.14). Mortality rates showed no significant difference between groups (OR = 1.40, 95% CI: 0.74 to 2.68; p = 0.30). Despite not reaching statistical significance, the consistent directional trend favoring early intervention supports its consideration when medically feasible, as even modest neurological improvements may be clinically meaningful in this devastating condition. These findings suggest that early surgical decompression does not increase mortality risk and may confer neurological benefits, supporting the development of institutional protocols prioritizing expedited intervention while maintaining rigorous perioperative safety standards.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.