@article{ref1,
title="Does surgical treatment within 4 hours after trauma have an influence on neurological remission in patients with acute spinal cord injury?",
journal="Therapeutics and clinical risk management",
year="2016",
author="Biglari, Bahram and Child, Christopher and Yildirim, Timur Mert and Swing, Tyler and Reitzel, Tim and Moghaddam, Arash",
volume="12",
number="",
pages="1339-1346",
abstract="BACKGROUND: The proper timing for surgery in patients with acute spinal cord injury is controversial. This study was conducted to detect if there is an advantage in early (within the first 4 hours after trauma) compared to late (between 4 and 24 hours after trauma) surgery on neurological outcome. <br><br>METHODS: In this single institution prospective cohort study, data were analyzed from 51 spinal cord injured patients with an average age of 43.4 (±19.2) years. The influence of early (29 patients within the first 4 hours) as opposed to late (22 patients between 4 and 24 hours) decompression was evaluated by comparing data for neurological outcome. Patients of the study collectively suffered acute spinal fractures from C2 to L3 (cervical 39.2%, thoracic 29.4%, and lumbal 21.6%) or nonosseous lesions (9.8%). American Spinal Injury Association (ASIA) Impairment Scale (AIS) grades were assessed at time of admission and 6 months after trauma or longer depending on the time of release. Surgical treatment included early stabilization and decompression within 24 hours. <br><br>RESULTS: No significant difference between improved neurological function, measured with the AIS, and an early or late surgery time can be seen (P=0.402). Furthermore, binary logistic regression shows no significant difference between sex or age, and AIS improvement as possible confounders. <br><br>CONCLUSION: In our study, all patients with spinal cord injury were treated with spine stabilization and decompression within the first 24 hours after trauma. Surgical decompression within the first 4 hours after trauma was not associated with improved neurological outcome compared to treatment between 4 and 24 hours. In a clinical context, this indicates that there is a time frame of at least 1 day in which optimal care is possible.<p /> <p>Language: en</p>",
language="en",
issn="1176-6336",
doi="10.2147/TCRM.S108856",
url="http://dx.doi.org/10.2147/TCRM.S108856"
}