Jonathan Dalton, Rachel Huang, Rajkishen Narayanan, Ian David Kaye, Christopher K Kepler
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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.</p><p><strong>Methods: </strong>A literature search was conducted of studies in PubMed Central and Cochrane Database related to timing in cervical spine trauma.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Operative Timing in Cervical Spine Trauma.\",\"authors\":\"Jonathan Dalton, Rachel Huang, Rajkishen Narayanan, Ian David Kaye, Christopher K Kepler\",\"doi\":\"10.1097/BSD.0000000000001707\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Narrative review.</p><p><strong>Objective: </strong>To review existing literature regarding surgical timing in cervical trauma with a focus on acute traumatic central cord syndrome.</p><p><strong>Summary of background data: </strong>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.</p><p><strong>Methods: </strong>A literature search was conducted of studies in PubMed Central and Cochrane Database related to timing in cervical spine trauma.</p><p><strong>Conclusions: </strong>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. 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引用次数: 0
摘要
研究设计叙述性综述:回顾有关颈部创伤手术时机的现有文献,重点关注急性创伤性中央脊髓综合征:创伤性中央脊髓综合征是最常见的不完全性脊髓损伤。大量基础科学文献提出了缺血性和继发性损伤驱动机制,这些机制是手术干预紧迫性的基础。然而,直到最近,临床文献才就急性外伤性中枢神经脊髓综合征早期手术干预的安全性、有效性和必要性达成了相对一致的意见:方法:对 PubMed Central 和 Cochrane 数据库中与颈椎创伤时机相关的研究进行了文献检索:最近,几篇重要的系统综述和共识声明都认可了早期(
Objective: To review existing literature regarding surgical timing in cervical trauma with a focus on acute traumatic central cord syndrome.
Summary of background data: 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: A literature search was conducted of studies in PubMed Central and Cochrane Database related to timing in cervical spine trauma.
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.
期刊介绍:
Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure.
Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.