Trung Ngo Dinh, Su Hoang Xuan, Chinh Dao Trong, Tam Nguyen Chi, Khanh Le Nam, Van Nam Do
Department of Surgical and Transplant Intensive Care Unit, Military Central Hospital 108, Viet Nam.
Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, HanoiViet Nam.
Brain Spine. 2025 Jul 10;5:104326. doi: 10.1016/j.bas.2025.104326. eCollection 2025.
Traumatic cervical spinal cord injury (SCI) frequently leads to severe neurological deficits. Early decompressive surgery, when performed shortly after the injury, is believed to improve outcomes. However, the impact of surgical timing, calculated from the moment of injury, and injury characteristics on neurological recovery remains poorly understood.
This study aims to assess the impact of early decompressive surgery and injury characteristics on neurological recovery in traumatic cervical SCI patients.
A retrospective case-control study was conducted at the 108 Central Military Hospital in Hanoi, Vietnam, between January 2018 and June 2023. Data collected included demographics, injury characteristics, time from injury to decompression surgery, and clinical outcomes at the 1-year follow-up.
Among the 193 patients initially screened, 156 met the inclusion criteria. Neurological recovery was observed in 44.2 % of patients. Early decompression within 24 h significantly improved recovery outcomes (OR = 3.12, p = 0.006). Injury at C1-C3 levels, longer spinal cord injury length, and severe spinal canal stenosis were associated with poorer recovery (OR = 0.34, p = 0.015; OR = 0.21, p < 0.001; OR = 0.34, p = 0.009, respectively). Prolonged ICU stay correlated with worse recovery (OR = 0.90, p = 0.002).
Early decompressive surgery, thorough assessment of injury characteristics, and minimizing ICU stay duration are critical for improving neurological recovery. These findings highlight the importance of timely surgery and strategic clinical management in enhancing recovery outcomes in traumatic cervical SCI patients.
创伤性颈脊髓损伤（SCI）常导致严重的神经功能缺损。早期减压手术若在损伤后不久进行，被认为可改善预后。然而，从受伤时刻算起的手术时机以及损伤特征对神经恢复的影响仍知之甚少。
本研究旨在评估早期减压手术和损伤特征对创伤性颈脊髓损伤患者神经恢复的影响。
于2018年1月至2023年6月在越南河内的第108中央军事医院进行了一项回顾性病例对照研究。收集的数据包括人口统计学资料、损伤特征、从受伤到减压手术的时间以及1年随访时的临床结局。
在最初筛查的193例患者中，156例符合纳入标准。44.2%的患者出现神经恢复。伤后24小时内进行早期减压显著改善了恢复结局（OR = 3.12，p = 0.006）。C1 - C3节段损伤、脊髓损伤长度较长以及严重的椎管狭窄与较差的恢复相关（OR分别为0.34，p = 0.015；OR = 0.21，p < 0.001；OR = 0.34，p = 0.009）。重症监护病房（ICU）住院时间延长与较差的恢复相关（OR = 0.90，p = 0.002）。
早期减压手术、对损伤特征进行全面评估以及尽量缩短ICU住院时间对于改善神经恢复至关重要。这些发现凸显了及时手术和策略性临床管理在提高创伤性颈脊髓损伤患者恢复结局方面的重要性。
