Comparison between nonoperative and operative care and timing of surgery in spinal cord injury

To determine whether neurological outcome is improved in traumatic spinal cord-injury patients who had time-related surgery. A retrospective evaluation of a nonconsecutive cohort of patients with a spinal cord injury (SCI) from C1 to L1 were reviewed. Data evaluated included patient ’s age, level of injury, neurologic exam according to the Frankel Grading System, the performance of surgery, mechanism of the time-related SCI decompression, and motor index score (MIS). The analysis included a total of 50 eligible patients. The neurologic and functional outcomes were recorded from hospital admission to the most recent follow- up. In the cases of SCI, no significant correlation between time-related spinal cord decompression and motor movement was found. A greater improvement in motor function, regardless of the timing of surgery was seen in cases of incomplete spinal cord injury (p=0.02). Complications related to the presence of SCI were similar in both operated and non- operated groups. The results of this study revealed no significant difference in neurologic outcomes between observation and early (within 24 hours after injury- mean: 15.2 hours) or late (more than 24 hours- mean: 11 days) surgery in patients with a traumatic SCI.