# A Review of the Literature on Surgical Management in the Acute Phase of Spinal Cord Injury: Expected Outcomes and the Influence of Surgical Timing

## TL;DR

This paper reviews the literature on when to perform surgery for spinal cord injuries to improve neurological outcomes.

## Contribution

The paper systematically reviews the influence of surgical timing on outcomes in acute spinal cord injury.

## Key findings

- Early decompressive surgery within 24 hours is supported for better neurological outcomes.
- Incomplete spinal cord injuries benefit most from timely surgical intervention.
- A systematic review of 43 studies highlights the importance of acute surgical management.

## Abstract

Certain mechanisms of injury to the spine can produce neurological impairment. Such phenomena are called spinal cord injuries (SCI). The management of SCI in the acute phase can prove challenging, especially in polytrauma patients, where an incomplete neurological deficit necessitates urgent surgical decompression. In order to investigate the expected outcomes and the influence of surgical timing in the surgical management in the acute phase of SCI, a systematic review of the literature was performed by examining online databases such as PubMed-NCBI, Web of Science, Cochrane Library, Scopus, and Embase to identify relevant scientific articles. Keywords (medical subject headings (MeSH) terms) used in the search included "spinal cord injury," "surgical decompression," "surgical timing," and "neurological outcomes”. Initially, 346 studies were identified, and after the application of the exclusion criteria, 43 studies were included in this review. The current body of literature supports early decompressive surgery, ideally within 24 hours of injury, as a guideline in the management of acute SCI. This timing is essential to raise the chances of neurological improvement in the presence of an incomplete SCI.