Meta-Analysis on the Effect of Hypothermia in Acute Spinal Cord Injury

Objective: Acute spinal cord injury (SCI) can result in debilitating motor, sensory, and au-tonomic dysfunction. As a treatment option, therapeutic hypothermia has been researched to inadequate pharmaceutical treatment, except for methylprednisolone. In this article, we systematically meta-analyzed to clarify the effect of hypothermia in acute SCI on neurologi-cal outcomes.Methods: The PubMed, Embase, Web of Science, and Cochrane clinical trial databases were systematically searched until June 30, 2022. The proportion of cases with improved neurological status after hypothermia in acute SCI were pooled with a random-effects mod-el. Subgroup analyses for the method of hypothermia and injury level were conducted.Results: Eight studies with a total of 103 patients were included. Hypothermia in acute SCI improved neurological function by 55.8% (95% confidence interval [CI]: 39.4%-72.1%). The subgroup analysis revealed that the pooled proportion of cases showing neurological improvement was higher with systemic hypothermia (70. 9%) (95% CI, 14. 9%-100%) than with local hypothermia (52. 5%) (95% CI, 40.4%-64.5%), although the subgroup differ-ence was not statistically significant (p = 0.53). Another subgroup analysis revealed that the proportion of cases with neurological improvement did not differ statistically between the cervical spine (61. 4%) (95% CI, 42.2%-80. 6%) and thoracic spine injury groups (59. 4%) (95% CI, 34.8%-84. 0%) (p = 0.90).Conclusion: This meta-analysis identified that more than 50% of patients showed neurolog-ical improvement after hypothermia following acute SCI in general. A multicenter, ran-domized, double-blind study with larger sample size is necessary to validate the findings further.

Automated summary

After hypothermia treatment following acute SCI, more than 50% of patients showed improvement in neurological function. The proportion of cases showing neurological improvement was higher in the systemic hypothermia group compared to the local hypothermia group, although the difference was not statistically significant. There was no statistically significant difference in the proportion of cases with neurological improvement between cervical spine and thoracic spine injury groups.