Impact of early decompression surgery and injury characteristics on neurological recovery following traumatic cervical spinal cord injury

Introduction: Traumatic cervical spinal cord injury (SCI) frequently leads to severe neurological deficits. Early decompressive surgery, when performed shortly after the injury, is believed to improve outcomes. However, the impact of surgical timing, calculated from the moment of injury, and injury...

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Main Authors: Ngo Dinh Trung, Hoang Xuan Su, Dao Trong Chinh, Nguyen Chi Tam, Le Nam Khanh, Do Van Nam
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Brain and Spine
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2772529425001456
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author Ngo Dinh Trung
Hoang Xuan Su
Dao Trong Chinh
Nguyen Chi Tam
Le Nam Khanh
Do Van Nam
author_facet Ngo Dinh Trung
Hoang Xuan Su
Dao Trong Chinh
Nguyen Chi Tam
Le Nam Khanh
Do Van Nam
author_sort Ngo Dinh Trung
collection DOAJ
description Introduction: Traumatic cervical spinal cord injury (SCI) frequently leads to severe neurological deficits. Early decompressive surgery, when performed shortly after the injury, is believed to improve outcomes. However, the impact of surgical timing, calculated from the moment of injury, and injury characteristics on neurological recovery remains poorly understood. Research question: This study aims to assess the impact of early decompressive surgery and injury characteristics on neurological recovery in traumatic cervical SCI patients. Material and methods: A retrospective case-control study was conducted at the 108 Central Military Hospital in Hanoi, Vietnam, between January 2018 and June 2023. Data collected included demographics, injury characteristics, time from injury to decompression surgery, and clinical outcomes at the 1-year follow-up. Results: Among the 193 patients initially screened, 156 met the inclusion criteria. Neurological recovery was observed in 44.2 % of patients. Early decompression within 24 h significantly improved recovery outcomes (OR = 3.12, p = 0.006). Injury at C1–C3 levels, longer spinal cord injury length, and severe spinal canal stenosis were associated with poorer recovery (OR = 0.34, p = 0.015; OR = 0.21, p < 0.001; OR = 0.34, p = 0.009, respectively). Prolonged ICU stay correlated with worse recovery (OR = 0.90, p = 0.002). Discussion and conclusion: Early decompressive surgery, thorough assessment of injury characteristics, and minimizing ICU stay duration are critical for improving neurological recovery. These findings highlight the importance of timely surgery and strategic clinical management in enhancing recovery outcomes in traumatic cervical SCI patients.
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spelling doaj-art-e24dab82e7fd45a0bd92cacad72973692025-08-20T02:36:23ZengElsevierBrain and Spine2772-52942025-01-01510432610.1016/j.bas.2025.104326Impact of early decompression surgery and injury characteristics on neurological recovery following traumatic cervical spinal cord injuryNgo Dinh Trung0Hoang Xuan Su1Dao Trong Chinh2Nguyen Chi Tam3Le Nam Khanh4Do Van Nam5Department of Surgical and Transplant Intensive Care Unit, Military Central Hospital 108, Viet NamInstitute of Biomedicine and Pharmacy, Vietnam Military Medical University, HanoiViet NamDepartment of Surgical and Transplant Intensive Care Unit, Military Central Hospital 108, Viet NamDepartment of Surgical and Transplant Intensive Care Unit, Military Central Hospital 108, Viet NamDepartment of Surgical and Transplant Intensive Care Unit, Military Central Hospital 108, Viet NamDepartment of Surgical and Transplant Intensive Care Unit, Military Central Hospital 108, Viet Nam; No. 1B Tran Hung Dao Street, Hai Ba Trung District, Hanoi, 100000, Viet Nam.Introduction: Traumatic cervical spinal cord injury (SCI) frequently leads to severe neurological deficits. Early decompressive surgery, when performed shortly after the injury, is believed to improve outcomes. However, the impact of surgical timing, calculated from the moment of injury, and injury characteristics on neurological recovery remains poorly understood. Research question: This study aims to assess the impact of early decompressive surgery and injury characteristics on neurological recovery in traumatic cervical SCI patients. Material and methods: A retrospective case-control study was conducted at the 108 Central Military Hospital in Hanoi, Vietnam, between January 2018 and June 2023. Data collected included demographics, injury characteristics, time from injury to decompression surgery, and clinical outcomes at the 1-year follow-up. Results: Among the 193 patients initially screened, 156 met the inclusion criteria. Neurological recovery was observed in 44.2 % of patients. Early decompression within 24 h significantly improved recovery outcomes (OR = 3.12, p = 0.006). Injury at C1–C3 levels, longer spinal cord injury length, and severe spinal canal stenosis were associated with poorer recovery (OR = 0.34, p = 0.015; OR = 0.21, p < 0.001; OR = 0.34, p = 0.009, respectively). Prolonged ICU stay correlated with worse recovery (OR = 0.90, p = 0.002). Discussion and conclusion: Early decompressive surgery, thorough assessment of injury characteristics, and minimizing ICU stay duration are critical for improving neurological recovery. These findings highlight the importance of timely surgery and strategic clinical management in enhancing recovery outcomes in traumatic cervical SCI patients.http://www.sciencedirect.com/science/article/pii/S2772529425001456Cervical spinal cord injuryNeurological recoveryEarly decompression surgerySpinal cord injury lengthPrognostic factors
spellingShingle Ngo Dinh Trung
Hoang Xuan Su
Dao Trong Chinh
Nguyen Chi Tam
Le Nam Khanh
Do Van Nam
Impact of early decompression surgery and injury characteristics on neurological recovery following traumatic cervical spinal cord injury
Brain and Spine
Cervical spinal cord injury
Neurological recovery
Early decompression surgery
Spinal cord injury length
Prognostic factors
title Impact of early decompression surgery and injury characteristics on neurological recovery following traumatic cervical spinal cord injury
title_full Impact of early decompression surgery and injury characteristics on neurological recovery following traumatic cervical spinal cord injury
title_fullStr Impact of early decompression surgery and injury characteristics on neurological recovery following traumatic cervical spinal cord injury
title_full_unstemmed Impact of early decompression surgery and injury characteristics on neurological recovery following traumatic cervical spinal cord injury
title_short Impact of early decompression surgery and injury characteristics on neurological recovery following traumatic cervical spinal cord injury
title_sort impact of early decompression surgery and injury characteristics on neurological recovery following traumatic cervical spinal cord injury
topic Cervical spinal cord injury
Neurological recovery
Early decompression surgery
Spinal cord injury length
Prognostic factors
url http://www.sciencedirect.com/science/article/pii/S2772529425001456
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