Lancet Neurol: Decompression surgery 24-36 hours after acute spinal cord injury is a key window to affect the recovery of nerve function in patients

Acute spinal cord injury (SCI) is caused by trauma, which can cause damage to sensation, movement or autonitive nerve function, and there is evidence that persistent compression after primary spinal cord injury can lead to reversible secondary damage, and timely intervention can reduce nerve tissue damage and improve pre- As a result, early decompression surgery intervention is one of the important ways to improve prognostication, but different studies have inconsistent time definitions of "early" and "delayed", and recently researchers objectively assessed the long-term effects of acute SCI post-decompression surgery on patient prognostication.
researchers analyzed data from four independent queues of individual patients over a period of December 1991 to March 2017.
Patients are layered according to the timing of decompression surgery, divided into early surgical groups (within 24 hours after spinal cord injury) and delayed surgical groups (24 hours after spinal cord injury), and the patient's nerve function is assessed according to the American Spinal Injury Association (ASIA) or the International Spinal Cord Injury Neuroclassifiation Standard (ISNCSCI).
end of the study was a 1-year exercise function score after spinal cord injury.
secondary endpoints include the American Spinal Cord Injury Association's Rating Rating (AIS), Upper Limb Movement Function, Lower Limb Movement Function, and Light Touch Needle Score Assessment.
study included 1,548 patients, of whom 1,031 (66.6%) completed a one-year endpoint assessment.
nerve function recovery in the early decompression surgical group (n-528) was better than in the delayed surgical group (n-1020): the overall motor function score of the early surgical group was increased by 23.7 points, while the delayed surgical group was increased by only 19.7 points. 7 points; light touch scores improved by 19.0 points in the early surgery group, while those in the delayed surgery group improved by 14.8 points; the needle scores in the early surgery group improved by 18.3 points; and the delayed surgery group improved by 14.2 points.
AIS improved well after 1 year in the early surgical group, and the degree of injury was lower.
AIS grading and surgical timing model studies show that when surgery decompression time is a continuous variable, decompression surgery is performed at 24-36h after spinal injury, and the total exercise score decreases sharply over time, but after 36h, the change in total exercise score stabilizes.
Exercise function evaluation and surgical timing study concluded that surgery decompression treatment within 24 hours of acute spinal cord injury was significantly related to improving neuro motor function in patients, and surgery 24-36 hours after injury was a key window period for good nerve recovery.
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