Optimal timing of surgical decompression in acute spinal cord injury

Objective: To evaluate the clinical evidence and determine recommendations regarding theoptimal timing of decompression surgery following acute cervical spinal cord injury. Methods:A MEDLINE search of the English literature was performed using the search terms spinal cordinjury, SCI, quadriplegia and paraplegia, which were paired with the terms surgery,decompression, and timing. To focus on the most recent and relevant evidence, only articlespublished in the last 15 years were considered for review. Results: Recent studies classifyingearly decompression surgery as <72 hours showed minimal to no improvement in patientoutcomes. However, studies where the decompression surgery occurred < 24 hours from injuryresulted in significant improvement. Conclusion: There is a benefit to performingdecompression surgery in<24 hours following acute cervical spinal cord injury. However,concerted efforts to operate within eight hours of injury are needed to further advance ourunderstanding of the optimal timing for decompression surgery.