# Hyperbaric Oxygen Therapy in Traumatic and Non-Traumatic Spinal Cord Injuries: Insights from Nearly Five Decades of Evidence with Single-Center Experience

## TL;DR

Hyperbaric oxygen therapy may help improve neurological outcomes in some spinal cord injury patients, but results depend on injury type and treatment timing.

## Contribution

A systematic review of nearly five decades of HBOT data in spinal cord injuries, highlighting response variability by etiology and timing.

## Key findings

- Neurological improvement is more common in incomplete spinal cord injuries treated with HBOT.
- Early initiation of HBOT is associated with better outcomes.
- Treatment response varies depending on injury etiology and timing.

## Abstract

What are the main findings?
HBOT is associated with neurological improvement in selected patients with a spinal cord injury.The treatment response varies according to etiology and timing of intervention.

HBOT is associated with neurological improvement in selected patients with a spinal cord injury.

The treatment response varies according to etiology and timing of intervention.

What are the implications of the main findings?
HBOT may serve as a valuable adjunct in the multidisciplinary management of spinal cord injuries.Standardized protocols and controlled trials are needed to define optimal indications and timing.

HBOT may serve as a valuable adjunct in the multidisciplinary management of spinal cord injuries.

Standardized protocols and controlled trials are needed to define optimal indications and timing.

Background: Hyperbaric oxygen therapy (HBOT) has been proposed as an adjunctive treatment for spinal cord injuries (SCIs) to mitigate a secondary injury and enhance neurological recovery. While the preclinical evidence is consistently supportive, clinical data remain heterogeneous across traumatic (TSCI) and non-traumatic (NTSCI) etiologies. Methods: A hybrid systematic review was conducted in accordance with the PRISMA 2020 guidelines and included an illustrative single-center clinical case. PubMed, OVID Medline, and Google Scholar were searched for studies published between 1978 and 2024. Due to methodological heterogeneity, qualitative synthesis was performed. Results: Fifty studies comprising 1102 patients were included. Neurological improvement was more frequently observed in incomplete injuries and when HBOT was initiated early. Conclusions: HBOT may represent a useful adjunct in selected SCI patients, although standardized protocols and controlled trials are required to better define its role.