Efficacy and safety of Cerebrospinal drains in preventing and managing spinal cord ischemia and Injury: a comprehensive systematic review and meta-analysis

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.