2024 Volume 38 Issue 3 Pages 394-398
At our hospital, all patients presenting with complete paralysis due to cervical spinal cord injury undergo decompression surgery by the posterior approach on an emergency basis. The median time from injury to surgery was 375 minutes, and the hospital stay was 57 days. Patients who underwent surgery within 12 hours of injury demonstrated a significantly higher rate of improvement by two or more AIS grades at discharge. Early decompression surgery (within 12 hours) is optimal for complete cervical cord injury ; however, its implementation is challenging. ICU management and intensive nursing care are essential in the acute and subacute phases of complete paralysis. However, transitioning to general ward management is problematic in patients with persistent paralysis.
Addressing this challenge entails aggregating severe cervical spinal cord injury patients in dedicated trauma centers staffed by board-certified spine surgeons who can perform early decompression surgery. Moreover, incorporating techniques such as durotomy and duroplasty for cases with substantial spinal cord swelling, along with exploring regenerative medicine options, may improve functional prognosis. Reassessing surgical indications and timing during the acute phase is imperative to optimize patient outcomes.
