Neurological Recovery after Traumatic Cervical XXXX Is Superior if Surgical Decompression and Instrumented Fusion Are Performed within 8 Hours versus 8 to 24 Hours after Injury: A Single Center Experience.

@entity1 @entity3510 @entity55 @entity1745 @entity1566
A prospective study was performed to evaluate the impact of surgical decompression (SD) and instrumented fusion within 8   h versus 8-24   h after injury on neurological recovery after cervical traumatic @entity1566 (tSCI) in @entity1 operated on in the UMC Ljubljana, Slovenia. Only @entity1 with the American @entity3510 Association (ASIA) Impairment Scale (AIS) grades of A through C and with MRI-confirmed @entity1745 were enrolled. The primary outcome was the change in AIS grade at the 6-month follow-up. Of the 48 enrolled @entity1 , 22 @entity1 who underwent surgery within 8   h (group 8   h) and 20 @entity1 who underwent surgery between 8 and 24   h (Group 8-24   h) after injury concluded the study. At admission, there was no statistically significant difference in AIS grade between the study groups. At the 6-month follow-up, an improvement of at least two AIS grades was found in 45.5% of @entity1 in group 8   h and in 10% of @entity1 in group 8-24   h (p=0.017). The median improvement in the ASIA motor score was 38.5 (10.0-61.0) motor points in group 8   h and 15.0 (8.8-34.0) motor points in group 8-24   h (p=0.0468). In a multivariate analysis, adjusted for the preoperative AIS grade and the degree of spinal canal compromise, the odds of an at least two-grade AIS improvement were at least 106% higher for @entity1 in group 8   h than for @entity1 in group 8-24   h (odds ratio=11.08, p=0.004). No statistically significant difference was found in the rate of perioperative complications, @entity55 , and the number of ventilator-dependent days or the mortality between the groups. Our results suggest that the @entity1 with tSCI who undergo SD within 8   h after injury have superior neurological outcomes than @entity1 who undergo SD 8-24   h after injury, without any increase in the rate of adverse effects.
