Outcomes of early surgical management versus late or no surgical intervention after acute spinal cord injury

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Study compared neurologic, medical, and functional outcomes of patients with acute spinal cord injury (SCI) who underwent surgery less than 72 hours after injury (early) versus those who had surgical treatment after 72 hours (late) and those who received non-surgical treatment. Neurologic outcomes were assessed with the American Spinal Injury Association (ASIA) Impairment Scale (AIS) motor and sensory levels, and motor index score. Medical complications examined included pneumonia, deep vein thrombosis and pulmonary embolism, pressure ulcers, autonomic dysreflexia, and rehospitalization. Functional outcomes included length of stay, hospital charges, and Functional Independence Measure (FIM) motor scores. Results showed that subjects in the early group were more likely to be women, have paraplegia, and have SCI caused by motor vehicle collisions. The non-surgical group was more likely to be older and have more incomplete injuries. ASIA motor index improvements were more likely in the non-surgical group. No differences between groups were found for changes in neurologic levels, AIS grade, or FIM motor efficiency.

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