Early versus delayed surgery for acute cervical spinal cord injury

The optimal timing of surgical intervention in cervical spinal cord injurie s has not been defined. The goals of the study were to investigate changes in neurologic status, length of hospitalization, and acute complications as sociated with surgery within 3 days of injury versus surgery more than 3 da ys after the injury. All patients undergoing surgical treatment for an acut e cervical spinal injury with neurologic deficit at two institutions betwee n March 1989 and May 1991 were reviewed retrospectively. Forty-three patien ts initially were evaluated. At one institution, patients with neurologic s pinal injuries had surgical intervention within 72 hours of injury. At the other institution, patients underwent immediate closed reduction with subse quent observation of neurologic status for 10 to 14 days before undergoing surgical stabilization. This study indicates that patients who sustain acut e traumatic injuries of the cervical spine with associated neurologic defic it may benefit from surgical decompression and stabilization within 72 hour s of injury. Surgery within 72 hours of injury in patients sustaining acute cervical spinal injuries with neurologic involvement is not associated wit h a higher complication rate. Early surgery may improve neurologic recovery and decrease hospitalization time in patients with cervical spinal cord in juries.