{"id":"4405056b-60a5-4bc1-a3df-a72239d25e70","slug":"ultra-early-surgery-in-complete-cervical-spinal-cord-injury-improves-neurological-recovery-a-single-center-retrospective-study","title":"Ultra-early surgery in complete cervical spinal cord injury improves neurological recovery: A single-center retrospective study","authors":["Davide Nasi","Paolo Ruscelli","Maurizio Gladi","Fabrizio Mancini","Maurizio Iacoangeli","Mauro Dobran"],"abstract":"Background: This study evaluated how the neurological outcome in patients operated on cervical spinal cord injury (SCI) was positively influenced by ultra-early surgery (UES). Methods: Between 2010 and 2017, 81 patients with traumatic cervical SCI were assigned to the UES group (<12 h after injury; UES) and ES group (surgery between 12 and 48 h after injury; ES). Additional variables evaluated for the two groups included; age, sex, comorbidities charlson comorbidity index (CCI), level of trauma, type of fracture, preoperative and ASIA scores, pre- and post-operative neuroradiological examinations, surgical approaches, and complications. Results: Forty-seven of 81 (58.02%) patients exhibited improved neurological function 12 months postoperatively; better outcomes were observed in the UES (29 of 40 [72.5%]) versus ES groups (18 of 41 [43.9%]) (P = 0,009). For the 26 patients with complete cervical SCI (ASIA A), ultra-early surgical decompression was associated with significantly greater neurological improvement versus ES (61.53% vs. 7.69%; P = 0.003). Further, more neurological improvement correlated with the younger age, better ASIA grade at admission, and ultra-early surgical timing (P = 0.037, P = 0.017, and P = 0.005, respectively), while CCI was correlated with improvement only in the univariate analysis (P = 0.005). Conclusion: Ultra-early surgical timing in SCI patients appeared to be the most important factor determining the extent of postoperative neurological improvement, particularly regarding motor function recovery.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/4405056b-60a5-4bc1-a3df-a72239d25e70/featured/hero-1781563730908.png","publishDate":"2019-10-18T00:00:00.000Z","doi":"10.25259/SNI_485_2019","categories":["Spine","Original Article"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2019/10/9715/SNI-10-207.pdf"}