Table 7.
Investigations Evaluating the Timing of Decompression on the Therapeutic Effectiveness and Neurological Outcome in Cervical Traumatic Spinal Cord Injury
| Investigator Year Journal |
Design | Cohort | AIS grade | Preop MRI | Timing (hours) | Postop MRI | IMLL | Extent of DEC. | F/UM | TE/AIS grade conversion |
|---|---|---|---|---|---|---|---|---|---|---|
| Vaccaro et al. Spine, 1997 |
PR | 62 | A-D | Yes | ≤72 and >120 | No | No | No | 11.5 | No effect |
| Guest et al. J. Neurosurg., 2002 |
RO | 50 | C-D | Yes | ≤24 and >24 | No | No | No | 36 | Not mentioned |
| Papadopoulos et al. J. Trauma 2002 | PO | 91 | A-D | Yes | <12 and >12 | No | No | No | 33 | Early superior |
| Sapkas and Papadakis J. Orthop. Surg. 2007 | RO | 67 | A-E | Yes | ≤72 and >72 | No | No | No | 48 | No effect |
| Lenehan et al. Spine 2010 | PO | 73 | C-D | Yes | ≤24 and >24 | No | No | No | 12 | No effect |
| Wilson et al. Spinal Cord 2012 | PO | 55 | A-D | Yes | <24 and ≥24 | No | No | No | 3 | Early superior |
| Fehlings et al. PLoS One 2012 | PO | 313 | A-D | Yes | <24 and ≥24 | No | No | No | 6 | Early superior |
| Jug et al. J. Neurotrauma 2015 | PO | 42 | A-C | Yes | ≤8 and 8-24 | No | No | No | 6 | Early superior |
| Dvorak et al. J. Neurotrauma 2015 | PO | 470 | A-D | Yes? | ≤24 and >24 | No | No | No | 3-6 | NM |
| Grassner et al. J. Neurotrauma 2016 | RO | 70 | A-D | Yes | ≤8 and 8-90 | No | No | No | 10 | Early superior |
| Bourassa-Moreau et al. J. Neurotrauma 2016 | PO | 20 | A | Yes | <24-≥24 | No | No | No | 5 | Early superior |
| Mattiassich et al. J. Neurotrauma 2017 | RO | 49 | A-D | Yes | <5 h and ≥5-24 | No | No | No | 6 | Late superior |
| Burke et al. Neurosurgery 2018 |
RO | 48 | A-D | Yes | ≤12,12-24,>24 | No | No | No | ACD | Early superior |
| Kim et al. World Neurosurg. 2018 | RO | 46 | A-D | Yes | ≤48 and >48 | No | No | No | 6 | No effect |
| Sewell et al. World Neurosurg. 2018 | RO | 95 | A-D | Yes | ≤24 and >24 | No | No | No | 6 | No effect |
| Current Study 2019 |
RO | 73 | A-C | Yes | ≤12,12-24,24-138.5 | Yes | Yes | Yes | 6 | No effect |
AIS, American Spinal Injury Association (ASIA) Impairment Scale; MRI, magnetic resonance imaging; IMLL, intramedullary lesion length; ACD, acute care discharge; DEC, decompression; F/U, follow-up; M, months; PO, prospective observational; PR, prospective randomized; RO, retrospective observational; TE, treatment effect.