Aleid Abdulsalam Mohammed, Abdullah Ahmed Ali E Al, Alshehri Salem Ahmed S, Alanzi Ryan Khater, Ayed Alanazi Omar, Isa Alkhayyat Safa, Chaurasia Bipin, Aldanyowi Saud Nayef
Department of surgery, Medical college, King Faisal University, Hofuf, Ahsa, 31982, Saudi Arabia.
Faculty of Medicine, King Faisal University, Hofuf, Ahsa, Saudi Arabia.
Neurosurg Rev. 2025 Jan 3;48(1):19. doi: 10.1007/s10143-024-03168-4.
Spinal cord ischemia and injury pose significant challenges in spinal surgery and traumatic events. Cerebrospinal drains are considered a potential intervention to mitigate these risks, although their efficacy and safety are uncertain. We conducted a comprehensive systematic review and meta-analysis to evaluate the efficacy and safety of cerebrospinal drains in preventing and managing spinal cord ischemia and injury. We systematically searched multiple electronic databases including PubMed, Scopus, Web of Science, and the Cochrane Library to identify relevant studies. Eligible studies included randomized controlled trials, cohort studies, and observational studies assessing the use of cerebrospinal drains in patients undergoing aortic surgeries. Data extraction and quality assessment were independently performed by two reviewers. The systematic review identified 34 studies meeting the inclusion criteria. The meta-analysis conducted using open meta-analyst software revealed a significant effect of cerebrospinal drains on preventing spinal cord ischemia spinal cord injury The pooled odds ratio (OR) in double-arm studies was estimated to be 0.457 (95% CI: 0.275, 0.760). Additionally, the pooled estimate of single-arm studies was estimated to be 0.050 (95% CI: 0.036, 0.065). However, minimal heterogeneity was observed across studies.Cerebrospinal drains may play a role in preventing and managing spinal cord ischemia and injury, but further research is required to confirm their efficacy and safety. Additional well-designed studies are needed to determine the optimal use of cerebrospinal drains in clinical practice.
脊髓缺血和损伤在脊柱手术和创伤事件中构成重大挑战。脑脊液引流被认为是减轻这些风险的一种潜在干预措施，尽管其疗效和安全性尚不确定。我们进行了一项全面的系统评价和荟萃分析，以评估脑脊液引流在预防和管理脊髓缺血和损伤方面的疗效和安全性。我们系统地检索了多个电子数据库，包括PubMed、Scopus、科学网和考克兰图书馆，以识别相关研究。符合条件的研究包括随机对照试验、队列研究和观察性研究，评估在接受主动脉手术的患者中使用脑脊液引流的情况。数据提取和质量评估由两名审阅者独立进行。系统评价确定了34项符合纳入标准的研究。使用开放元分析软件进行的荟萃分析显示，脑脊液引流对预防脊髓缺血和脊髓损伤有显著效果。双臂研究中的合并比值比（OR）估计为0.457（95%CI：0.275，0.760）。此外，单臂研究的合并估计值估计为0.050（95%CI：0.036，0.065）。然而，各研究间观察到的异质性极小。脑脊液引流可能在预防和管理脊髓缺血和损伤中发挥作用，但需要进一步研究以证实其疗效和安全性。需要更多设计良好的研究来确定脑脊液引流在临床实践中的最佳使用方法。
