Kaye I David, Vaccaro Alex R
Department Orthopedic and Neurological Surgery Rothman Institute, Thomas Jefferson University Hospital, 925 Chestnut Street, Philadelphia, PA 19107 USA.
Spinal Cord Ser Cases. 2018 Feb 22;4:15. doi: 10.1038/s41394-018-0043-1. eCollection 2018.
Spinal cord injury can be a life-altering trauma for patients and can be costly to patients and society alike. Generally recognized as biphasic, these injuries have both primary and secondary drivers. Although the primary insult is largely unavoidable, prevention of secondary injury mechanisms-and the resultant cascade-has been a target of substantial research. Continued spinal cord compression has been recognized as one of several deleterious secondary mechanisms, and decompressive and stabilization surgery has been routinely used for neuroprotection in this setting. Numerous biomechanical and animal studies have confirmed its potential utility. More recently, several high-quality randomized trials have concluded that early surgery for spinal cord injury improves rates of recovery when compared with delayed or nonoperative management. Herein, we argue that early surgery for spinal cord injury with continued cord compression offers significant benefit and should be undertaken when not contraindicated.
