Timing of surgery following spinal cord injury

BACKGROUND: The optimal timing for surgical intervention after traumatic spinal injuries with spinal cord injury remains unclear. DESIGN: Literature review. FINDINGS: Multiple laboratory investigations (in animal models) and many clinical studies suggest better neurological outcomes with early surgical intervention. Conclusive evidence (well-designed randomized, controlled studies), however, is lacking, partly due to the logistics involved in executing such an investigation. Early surgery also appears to decrease the incidence of complications, reduces hospital stay, and helps reduce costs associated with acute management. CONCLUSION: Early surgical treatment is beneficial in terms of reducing complications, length of stay, and hospital costs. Further studies are needed to clearly demonstrate the impact of operative timing on neurological outcome.