{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T11:58:16Z","timestamp":1793447896922,"version":"4.5.0"},"reference-count":22,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec id=\"S0317167126105666_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To compare neurological and functional outcomes after ultra-early microdiscectomy (\u226412 h) versus later surgery (12\u201324 h, 24\u201348 h, &gt;48 h) in adults with acute lumbar disc herniation presenting with motor weakness and\/or cauda equina syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167126105666_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We retrospectively studied 300 consecutive adults undergoing emergency microdiscectomy (2015\u20132025) at a tertiary center. Patients were grouped by time from presentation to surgery (\u226412 h, 12\u201324 h, 24\u201348 h, &gt;48 h). Primary outcomes were motor recovery (Medical Research Council scale) and pain improvement; secondary outcomes were complications, length of stay (LOS), recurrent emergency visits and recurrent herniation. Nonparametric tests and logistic regression were used with a prespecified significance level of\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167126105666_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Ultra-early surgery was associated with more rapid immediate motor gains, most notably in plantarflexion\/dorsiflexion, and shorter LOS (\u226412 h: 3.8 days; &gt;48 h: 6.2 days). Over the \u226448 h window, long-term motor recovery did not differ among \u226412 h, 12\u201324 h and 24\u201348 h groups. Rates of complications, recurrent emergency visits and recurrent herniation did not vary by timing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167126105666_as4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In acute presentations with neurological deficits, microdiscectomy performed within 48 h remains the key threshold for favorable outcomes. Ultra-early surgery (\u226412 h) appears to accelerate early neurological recovery and reduce LOS in selected acute cases, without evidence of superior long-term motor outcomes versus other \u226448 h windows. Prospective, symptom-stratified studies are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/cjn.2026.10566","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T03:15:41Z","timestamp":1770866141000},"page":"1-8","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Surgical Timing on Neurological Outcomes in Acute Lumbar Disc Herniation: Ultra-Early Versus Delayed Microdiscectomy"],"prefix":"10.1017","author":[{"given":"Abdullah","family":"llleyyan","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02zwb6n98","id-type":"ROR","asserted-by":"publisher"}],"name":"Neurosurgery, Neuroscience Institute, Hamad Medical Corporation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar M.","family":"Shihadeh","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02zwb6n98","id-type":"ROR","asserted-by":"publisher"}],"name":"Neurosurgery, Neuroscience Institute, Hamad Medical 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