{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:50:29Z","timestamp":1792083029113,"version":"4.4.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T00:00:00Z","timestamp":1600387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T00:00:00Z","timestamp":1600387200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neurotrauma Reports"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>Convincing clinical evidence exists to support early surgical decompression in the setting of cervical spinal cord injury (SCI). However, clinical evidence on the effect of early surgery in patients with thoracic and thoracolumbar (from T1 to L1 [T1\u2013L1]) SCI is lacking and a critical knowledge gap remains. This randomized controlled trial (RCT) sought to evaluate the safety and efficacy of early (&lt;24\u2009h) compared with late (24\u201372\u2009h) decompressive surgery after T1\u2013L1 SCI. From 2010 to 2018, patients (\u226516 years of age) with acute T1\u2013L1 SCI presenting to a single trauma center were randomized to receive either early (&lt;24\u2009h) or late (24\u201372\u2009h) surgical decompression. The primary outcome was an ordinal change in American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade at 12-month follow-up. Secondary outcomes included complications and change in ASIA motor score (AMS) at 12 months. Outcome assessors were blinded to treatment assignment.<\/jats:p>\n                  <jats:p>\n                    Of 73 individuals whose treatment followed the study protocol, 37 received early surgery and 36 underwent late surgery. The mean age was 29.74\u2009\u00b1\u200911.4 years. In the early group 45.9% of patients and in the late group 33.3% of patients had a \u22651-grade improvement in AIS (odds ratio [OR] 1.70, 95% confidence interval [CI]: 0.66-4.39,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.271); significantly more patients in the early (24.3%) than late (5.6%) surgery group had a \u22652-grade improvement in AIS (OR 5.46, 95% CI: 1.09-27.38,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.025). There was no statistically significant difference in the secondary outcome measures. Surgical decompression within 24\u2009h of acute traumatic T1\u2013L1 SCI is safe and is associated with improved neurological outcome, defined as at least a 2-grade improvement in AIS at 12 months.\n                  <\/jats:p>","DOI":"10.1089\/neur.2020.0027","type":"journal-article","created":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T11:52:35Z","timestamp":1600429955000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":35,"title":["A Randomized Controlled Trial of Early versus Late Surgical Decompression for Thoracic and Thoracolumbar Spinal Cord Injury in 73 Patients"],"prefix":"10.1177","volume":"1","author":[{"given":"Ali","family":"Haghnegahdar","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Shiraz University of Medical Sciences, Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Behjat","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shiraz University of Medical Sciences, Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soheil","family":"Saadat","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of California, Irvine, Irvine, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jetan","family":"Badhiwala","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada."},{"name":"Division of Neurosurgery, Krembil Brain Institute, Toronto Western Hospital, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid Reza","family":"Farrokhi","sequence":"additional","affiliation":[{"name":"Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran."},{"name":"Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin","family":"Niakan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shiraz University of Medical Sciences, Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keyvan","family":"Eghbal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shiraz University of Medical Sciences, Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehsan","family":"Barzideh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shiraz University of Medical Sciences, Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abtin","family":"Shahlaee","sequence":"additional","affiliation":[{"name":"Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran."},{"name":"Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fariborz","family":"Ghaffarpasand","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shiraz University of Medical Sciences, Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Ghodsi","sequence":"additional","affiliation":[{"name":"Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander R.","family":"Vaccaro","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Neurosurgery, Thomas Jefferson University and the Rothman Institute, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsen","family":"Sadeghi-Naini","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Fehlings","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada."},{"name":"Division of Neurosurgery, Krembil Brain Institute, Toronto Western Hospital, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James David","family":"Guest","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Miami Project to Cure Paralysis, University of Miami, Miami, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pegah","family":"Derakhshan","sequence":"additional","affiliation":[{"name":"Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vafa","family":"Rahimi-Movaghar","sequence":"additional","affiliation":[{"name":"Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran."},{"name":"Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran."},{"name":"Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran."},{"name":"Pre-Hospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran."},{"name":"Tissue Repair Laboratory, Institute of Biochemistry and Biophysics (IBB), University of Tehran, Tehran, 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