Early surgical decompression for traumatic spinal cord injury

Traumatic spinal cord injury (SCI) is a tragic and often irreversible event that can cause paralysis, loss of sensation, chronic pain, and psychological deficits. To decrease the burden associated with these injuries, health care providers are motivated to develop treatment strategies for neurological recovery for SCI. One existing intervention is surgical decompression, which refers to procedures intended to reduce injury-related pressure on areas of the spinal cord. These interventions can’t repair the initial injury, but they often can decrease pain, numbness, and other symptoms associated with SCI.

Although clinicians tend to agree that surgical decompression is a useful intervention, optimal timing remains controversial. Some research suggests that surgical decompression is effective within a day after initial injury, while other research maintains that surgical decompression should be administered within eight hours to achieve optimal outcomes. A Korean research team addressed this controversy by determining if early surgical decompression (applied within eight hours) is more effective than a late procedure (applied within 8-24 hours) in terms of neurological improvement. The team analyzed data from 56 patients who received surgical decompression within 24 hours of SCI. They found that those patients who received surgical decompression within eight hours of injury showed better neurological recovery than those who received a later procedure. Patients who received surgical decompression more than eight hours after injury were more likely to need longer hospice care and experienced more injury-related complications.

Surgical decompression is a valuable tool for decreasing the negative outcomes associated with SCI. Although the initial injury can’t be reversed, interventions aimed to reduce secondary outcomes associated with injury can significantly improve patients’ comfort and functioning during the recovery period. Timely intervention is critical for ensuring best outcomes. As a result, early detection and diagnosis of SCI play an important role in the treatment process.

Lee DY, Park YJ, Song SY, et al. The importance of early surgical decompression for acute traumatic spinal cord injury. Clinics in Orthopedic Surgery. (2018).

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