Iranian Journal of Neurosurgery

en Effect of Granulocyte Colony-Stimulating Factor (G-CSF) on Improving Impairment Scale After Acute Spinal Cord Injury: An Individual Participant Data Meta-Analysis Spine Review Background and Aim: The present study was conducted to investigate the effects of granulocyte colony-stimulating factor (G-CSF) after acute spinal cord injury on increasing a grade of improvement entitled American spinal cord injury association impairment scale (AIS) as an individual participant data (IPD) meta-regression analysis of clinical trials. Methods and Materials/Patients: According to our search strategy, four studies were selected. Multilevel ordered logistic regression modeling was used to predict AIS grade with G-CSF administration and time variable (first day and a 3-month follow-up). The IDs of the studies as well as the time series variable were imported to the random part of the model. Odds ratio (OR) and 95% confidence interval (CI) were reported. Results: A total of 277 samples were studied. A fixed effect model was performed at first. Accordingly, using G-CSF was associated with increased AIS grade (lower impairment) (OR=1.503, 95% CI=1.110-2.035) adjusted with time series (OR=1.868, 95% CI=1.378-2.532). In the mixed effect model, G-CSF was again associated with increased AIS grade (OR=1.780, 95% CI=1.301- 2.436) adjusted with time series (OR=2.152, 95% CI=1.406-3.294). Conclusion: The present meta-analysis showed the protective effect of GCS-F observed as an improvement in AIS grade. This protecting effect was further after adjusting the random effects of time series and individual studies. Although multilevel modeling could reduce our limitations, it should be regarded that the number of trials was not enough to establish strong conclusions. Spinal cord injury, Methylprednisolone, Meta-analysis, Multilevel analysis, Statistical models, Evidence-based medicine 0 0 http://irjns.org/browse.php?a_code=A-10-40-1&slc_lang=en&sid=1 Seyyed Amir Yasin Ahmadi yasin_ahmadi73@yahoo.com 10031947532846007998 10031947532846007998 No Neuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran Mohammad Javad Nourmohammadi mohammadjavad328@gmail.com 10031947532846007999 10031947532846007999 No Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran Ahmed Sayahi ahmedmedsciences@gmail.com 10031947532846008000 10031947532846008000 No Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran Babak Alijani babakalij@gmail.com 10031947532846008001 10031947532846008001 No Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran and Department of Neurosurgery, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Shahrokh Yousefzadeh-Chabok sh.yousefzadeh@gmail.com 10031947532846008002 10031947532846008002 No Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran and Department of Neurosurgery, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Jafar Rezaian jafarrezaian@gmail.com 10031947532846008003 10031947532846008003 Yes Department of Anatomical Sciences, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran