The role and timing of decompression in acute spinal cord injury: what do we know? What should we do?

摘要: The management of acute spinal cord injury has traditionally concentrated on preventative measures as well as, for the better part previous century, conservative care. Pharmacologic interventions, in particular intravenous methylprednisolone therapy, have shown modest improvements clinical trials and are still undergoing evaluation. More recent interest focused role surgical reduction decompression, particularly "early" surgery. A review current evidence available literature suggests that there is no standard care regarding timing decompression. There insufficient data to support overall treatment standards or guidelines this topic. are, however, Class II indicating early surgery (<24 hours) may be done safely after SCI. Furthermore, III suggest a urgent decompression setting 1) bilateral facet dislocation 2) incomplete with neurologically deteriorating patient. Whereas biologic from experimental studies animals improve neurologic recovery SCI, relevant time frame humans remains unclear. To date, patients SCI only supported by limited accordingly can considered practice option. Accordingly, strong rationale undertake prospective, controlled evaluate