Abstract
Traumatic spinal cord injury (TSCI) is frequent. Timely diagnosis and treatment have
reduced the mortality, but the long-term recovery of neurologic functions remains
ominous. After TSCI, tissue bleeding, edema, and adhesions lead to an increase in
the intraspinal pressure, further causing the pathophysiologic processes of ischemia
and hypoxia and eventually accelerating the cascade of secondary spinal cord injury.
Timely surgery with appropriate decompression strategies can reduce that secondary
injury. However, disagreement about the safety and effectiveness of decompression
surgery and the timing of surgery still exists. The level and severity of spinal cord
injury do have an impact on the timing of surgery; therefore, TSCI subpopulations
may benefit from early surgery. Early surgery perhaps has little effect on recovery
from complete TSCI but might be of benefit in patients with incomplete injury. Early
decompression should be considered in patients with incomplete cervical TSCI. Patient
age should not be used as an exclusion criterion for early surgery. The best time
point for early surgery is although influenced by the shortest duration to thoroughly
examine the patient's condition and stabilize the patient's state. After the patient's
condition is fully evaluated, we can perform the surgical modality of emergency myelotomy
and decompression. Therefore, a number of conditions should be considered, such as
standardized decompression methods, indications and operation timing to ensure the
effectiveness and safety of early surgical intervention, and promotion of the functional
recovery of residual nerve tissue.
Keywords
TSCI - surgical decompression - surgical timing - functional recovery
