神经外科医师学会系统评价和循证指南:胸腰椎创伤患者的评估和治疗:手术干预时机。
Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Evaluation and Treatment of Patients With Thoracolumbar Spine Trauma: Timing of Surgical Intervention.
机构信息
St. Louis Minimally Invasive Spine Center, St. Louis, Missouri.
Department of Neurosurgery, University of Utah, Salt Lake City, Utah.
出版信息
Neurosurgery. 2019 Jan 1;84(1):E53-E55. doi: 10.1093/neuros/nyy362.
QUESTION
Does early surgical intervention improve outcomes for patients with thoracic and lumbar fractures?
RECOMMENDATIONS
There is insufficient and conflicting evidence regarding the effect of timing of surgical intervention on neurological outcomes in patients with thoracic and lumbar fractures. Strength of Recommendation: Grade Insufficient It is suggested that "early" surgery be considered as an option in patients with thoracic and lumbar fractures to reduce length of stay and complications. The available literature has defined "early" surgery inconsistently, ranging from <8 h to <72 h after injury. Strength of Recommendation: Grade B The full version of the guideline can be reviewed at: https://www.cns.org/guideline-chapters/congress-neurological-surgeons-systematic-review-evidence-based-guidelines/chapter_10.
问题
早期手术干预是否能改善胸腰椎骨折患者的预后?
建议
关于手术时机对胸腰椎骨折患者神经结局的影响,目前的证据不足且相互矛盾。
推荐强度
证据等级不足
建议胸腰椎骨折患者选择早期手术,以减少住院时间和并发症。但可用文献对“早期”手术的定义不一致,范围从受伤后<8 h 到<72 h。
推荐强度
证据等级 B