{"id":"f67e8647-9bc3-4974-851f-9c94b2e33c97","slug":"evaluating-the-role-of-surgical-timing-on-clinical-outcomes-in-traumatic-spinal-cord-injury-a-systematic-review-and-meta-analysis","title":"Evaluating the role of surgical timing on clinical outcomes in traumatic spinal cord injury: A systematic review and meta-analysis","authors":["Tommy Alfandy Nazwar","Farhad Bal’afif","Donny Wisnu Wardhana","Fachriy Bal’afif","Christin Panjaitan"],"abstract":"Background: This systematic review and meta-analysis aimed to evaluate the impact of surgical timing on neurological and functional outcomes in patients with traumatic spinal cord injury (TSCI). Methods: A comprehensive literature search was conducted in PUBMED and ScienceDirect databases for studies published between 2015 and 2025, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies comparing surgical timing (≤12 h, ≤24 h, and >24 h) were included. Results: A total of 22 comparative studies comprising 2,395 patients were included. Among them, 346 underwent ultra-early decompression (≤12 h), 1,140 underwent early surgery (≤24 h), and 908 underwent delayed surgery (>24 h). Ultra-early surgery (≤12 h) significantly improved neurological outcomes compared to surgery after 12 h (odds ratio [OR] 2.30; 95% confidence interval [CI]: 1.69–3.14; P P P = 0.19), scores at 1 year significantly favored the ≤24-h group (MD 4.90; 95% CI: 2.84–6.95; P P = 0.04), with no significant differences in mortality or major complications. Conclusion: Surgical decompression within 24 h, especially within 12 h, is associated with significantly better neurological recovery, improved long-term motor outcomes, and shorter hospitalization, without increased mortality or major complications. These findings underscore the critical role of timely surgical intervention in acute TSCI management.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/f67e8647-9bc3-4974-851f-9c94b2e33c97/featured/hero-1781558393189.png","publishDate":"2025-08-29T00:00:00.000Z","doi":"10.25259/SNI_678_2025","categories":["Trauma","Review Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/f67e8647-9bc3-4974-851f-9c94b2e33c97/pdf"}