Table 1.

Patient, Intervention, Comparators, and Outcomes (PICO).

Study Component	Inclusion	Exclusion
Participants	Adults with traumatic acute spinal cord injury (complete or incomplete)	Pediatric patients
		Pregnancy
		Penetrating injuries to spinal cord
		Cord compression due to tumor, hematoma, degenerative disease (eg, CSM)
		Patients without neurological deficit following trauma
Intervention	Early decompression (≤24 hours) via surgery or traction
Comparators	Delayed decompression (>24 hours) via surgery or via traction
	Conservative therapy
Outcomes	Efficacy/Effectiveness
	Neurologic outcomes (eg, Frankel Grade, American Spinal Injury Association Impairment Scale)
	Change in grade
	Change in motor scores
	Change in sensation
	Functional or Patient Reported Outcomes
	Functional Independence Measure, ambulatory function, others
	Administrative Outcomes
	Length of stay (intensive care unit, hospital, etc)
	Safety Outcomes
	Complications, adverse events
	Death
	Postinjury medical complications
Study design	Comparative studies that control for baseline status	Animal studies
	Focus will be on studies with the least potential for bias (RCTs and high-quality comparative studies)	Nonclinical studies
		Case series
		n < 10 per treatment arm
		Studies that did not control for baseline neurologic status
		Studies with different definitions of early and late decompression
Publication	Studies in any language with abstracts published in peer-reviewed journals	Abstracts, editorials, letters
		Duplicate publications of the same study that do not report on different outcomes
		Single reports from multicenter trials
		White papers
		Narrative reviews
		Proceedings/abstracts from meetings
		Articles identified as preliminary reports when results are published in later versions

Abbreviations: CSM, cervical spondylotic myelopathy; RCT, randomized controlled trial.