• Yann Facchinello, Andréane Richard-Denis, Marie Beauséjour, Cynthia Thompson, and Jean-Marc Mac-Thiong.
• Department of Surgery, Faculty of Medicine, University of Montreal, Pavillon Roger-Gaudry, S-749, C.P. 6128, succ. Centre-ville, Montreal, Quebec, H3C 3J7, Canada.
• Spinal Cord. 2018 Jul 1; 56 (7): 687-694.

Study DesignPost hoc analysis of prospectively collected data.ObjectivesAssess the influence of surgical timing on neurological recovery using classification tree analysis in patients sustaining cervical traumatic spinal cord injury.SettingHôpital du Sacré-Coeur de Montreal METHODS: 42 patients sustaining cervical SCI were followed for at least 6 months post injury. Neurological status was assessed from the American Spinal Injury Association impairment scale (AIS) and neurological level of injury (NLI) at admission and at follow-up. Age, surgical timing, AIS grade at admission and energy of injury were the four input parameters. Neurological recovery was quantified by the occurrence of improvement by at least one AIS grade, at least 2 AIS grades and at least 2 NLI.ResultsProportion of patients that improved at least one ASIA grade was higher in the group that received early surgery (75 vs. 41 %). The proportion of patients that improved two AIS grades was also higher in the group that received early surgery (67 vs. 38 %). Finally, 30 % of the patients that received early decompression improved two NLI as compared with 0% in the other group. Early surgery was also associated with a non-statistically significant improvement in functional recovery.ConclusionsNeurological recovery of patients sustaining cervical traumatic spinal cord injury can be improved by early decompression surgery performed within 19 h post trauma.SponsorshipU.S. Army Medical Research and Material Command, Rick Hansen Institute.

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