Operative Timing in Cervical Spine Trauma.
Journal
Clinical spine surgery
ISSN: 2380-0194
Titre abrégé: Clin Spine Surg
Pays: United States
ID NLM: 101675083
Informations de publication
Date de publication:
01 Nov 2024
01 Nov 2024
Historique:
received:
26
08
2024
accepted:
23
09
2024
medline:
31
10
2024
pubmed:
31
10
2024
entrez:
31
10
2024
Statut:
ppublish
Résumé
Narrative review. To review existing literature regarding surgical timing in cervical trauma with a focus on acute traumatic central cord syndrome. Traumatic central cord syndrome is the most common incomplete spinal cord injury. Substantial basic science literature has proposed ischemic and secondary injury-driven mechanisms underpinning the urgency of operative intervention. However, only recently has a relative consensus emerged in the clinical literature regarding the safety, efficacy, and necessity of early operative intervention for acute traumatic central cord syndrome. A literature search was conducted of studies in PubMed Central and Cochrane Database related to timing in cervical spine trauma. Recently, several major systematic reviews and consensus statements have endorsed the importance and safety of early (<24 h) operative decompression in the setting of traumatic spinal cord injury. Despite decades of conflicting data, a similar trend appears to be emerging for traumatic central cord syndrome. These clinical developments join a large body of basic science work regarding the importance of early decompressive surgery in relieving acute ischemic insult and minimizing the effects of secondary injury. However, further work is needed to delineate optimal surgical timing, especially regarding "ultra-early" (<8 h) protocols, and to aid in creating accelerated screening pathways.
Sections du résumé
STUDY DESIGN
METHODS
Narrative review.
OBJECTIVE
OBJECTIVE
To review existing literature regarding surgical timing in cervical trauma with a focus on acute traumatic central cord syndrome.
SUMMARY OF BACKGROUND DATA
BACKGROUND
Traumatic central cord syndrome is the most common incomplete spinal cord injury. Substantial basic science literature has proposed ischemic and secondary injury-driven mechanisms underpinning the urgency of operative intervention. However, only recently has a relative consensus emerged in the clinical literature regarding the safety, efficacy, and necessity of early operative intervention for acute traumatic central cord syndrome.
METHODS
METHODS
A literature search was conducted of studies in PubMed Central and Cochrane Database related to timing in cervical spine trauma.
CONCLUSIONS
CONCLUSIONS
Recently, several major systematic reviews and consensus statements have endorsed the importance and safety of early (<24 h) operative decompression in the setting of traumatic spinal cord injury. Despite decades of conflicting data, a similar trend appears to be emerging for traumatic central cord syndrome. These clinical developments join a large body of basic science work regarding the importance of early decompressive surgery in relieving acute ischemic insult and minimizing the effects of secondary injury. However, further work is needed to delineate optimal surgical timing, especially regarding "ultra-early" (<8 h) protocols, and to aid in creating accelerated screening pathways.
Identifiants
pubmed: 39480047
doi: 10.1097/BSD.0000000000001707
pii: 01933606-202411000-00004
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
388-394Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
C.K.K. Clinical Spine Surgery—editorial or governing board, Inion—IP royalties, Regeneration Technologies, Inc.—research support. The remaining authors declare no conflict of interest.
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