{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T21:43:59Z","timestamp":1787521439270,"version":"build-2736575974"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Spinal cord injury is a devastating clinical condition that causes secondary damage, which can be prevented with some treatments. Early surgical decompression may have a beneficial effect and lead to a better neurological outcome. This study aims to demonstrate the effectiveness of early compared with delayed surgical decompression to evaluate neurological improvement in patients with traumatic spinal cord injury. A systematic review and meta-analysis were conducted following the PRISMA-2020 (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Until April 2024, PubMed, Scopus, Web of Science, and Embase were searched for randomized controlled clinical trials. The primary outcome is an improvement of one grade or more on the American Spinal Injury Association Impairment Scale at 12 months' follow-up. Secondary outcomes included hospital stay, postoperative complications, and mortality. Of the 4,101 records identified, 4 studies and 430 patients were included. A statistically significant difference was found in favor of the early surgical decompression group regarding neurological improvement (mean difference 0.88, 95% confidence interval [CI]\u2009=\u2009\u20130.03 to 1.73, p\u2009=\u20090.04). Also, in patients with complete spinal cord injuries (relative risk [RR] 3.65, 95% CI\u2009=\u20091.10\u201312.17, p\u2009=\u20090.03) reduction of postoperative complications was observed in the early group (RR 0.42; 95% CI\u2009=\u20090.20\u20130.88, p\u2009=\u20090.02). Regarding hospital stay, there were no significant differences between the two groups (RR \u20137.95, 95% CI\u2009=\u2009\u201318.53 to 2.63, p\u2009=\u20090.14) and mortality (RR\u2009=\u20091.27, 95% CI\u2009=\u20090.30\u20135.38, p\u2009=\u20090.75). Our study demonstrates that early surgical decompression within the first 24\u2009hours after spinal cord injury leads to better neurological outcomes with statistical significance. Furthermore, statistically significant results were found in favor of early surgical decompression in patients with complete spinal cord injuries and to statistically reduce the risk of complications in the early group.<\/jats:p>","DOI":"10.1055\/s-0044-1801373","type":"journal-article","created":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T19:39:51Z","timestamp":1735587591000},"page":"199-210","source":"Crossref","is-referenced-by-count":6,"title":["Early versus Delayed Surgical Decompression in Spinal Cord Injury: A Systematic Review and Meta-Analysis"],"prefix":"10.1055","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6192-2218","authenticated-orcid":false,"given":"Gino","family":"Vasquez-Paredes","sequence":"additional","affiliation":[{"name":"School of Medicine, Antenor Orrego Private University, Trujillo, Peru"},{"name":"Department of Neurosurgery, Belen Hospital of Trujillo, Trujillo, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Zavaleta-Corvera","sequence":"additional","affiliation":[{"name":"School of Medicine, Antenor Orrego Private University, Trujillo, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Caballero-Alvarado","sequence":"additional","affiliation":[{"name":"School of Medicine, Antenor Orrego Private University, Trujillo, Peru"},{"name":"Department of Surgery, Regional Hospital of Trujillo, Trujillo, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"issue":"24","key":"ref1","doi-asserted-by":"crossref","first-page":"3362","DOI":"10.1089\/neu.2017.5132","article-title":"Functional outcomes in individuals undergoing very early (< 5\u2009h) and early (5-24\u2009h) surgical decompression in traumatic cervical spinal cord injury: analysis of neurological improvement from the Austrian spinal cord injury study","volume":"34","author":"G Mattiassich","year":"2017","journal-title":"J Neurotrauma"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1186\/s13018-019-1341-4","article-title":"Early versus late surgery after cervical spinal cord injury: a Japanese nationwide trauma database study","volume":"14","author":"C Tanaka","year":"2019","journal-title":"J Orthop Surg Res"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"106098","DOI":"10.1016\/j.ijsu.2021.106098","article-title":"Comparative analysis of the efficacy of early and late surgical intervention for acute spinal cord injury: a systematic review and meta-analysis based on 16 studies","volume":"94","author":"Y Qiu","year":"2021","journal-title":"Int J Surg"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1080\/10790268.2016.1165448","article-title":"Surgical management of patients following traumatic spinal cord injury: Identifying barriers to early surgery in a specialized spinal cord injury center","volume":"41","author":"C Thompson","year":"2018","journal-title":"J Spinal Cord Med"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"e185","DOI":"10.1016\/j.wneu.2020.04.230","article-title":"The impact of urgent (<8\u2009hours) decompression on neurologic recovery in traumatic spinal cord injury: a meta-analysis","volume":"140","author":"Y Ma","year":"2020","journal-title":"World Neurosurg"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.aott.2017.12.001","article-title":"Early surgical decompression within 8\u2009hours for traumatic spinal cord injury: Is it beneficial? 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