{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T05:43:27Z","timestamp":1782625407006,"version":"3.54.5"},"reference-count":51,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T00:00:00Z","timestamp":1695859200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82072476"],"award-info":[{"award-number":["82072476"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Currently, there exists considerable debate surrounding the optimal treatment approaches for different subtypes of patients with spinal cord injury (SCI). The purpose of this study was to conduct a comparative analysis of the benefits associated with conservative treatment and treatments with different surgical periods for patients diagnosed with acute traumatic central cord syndrome (ATCCS) and multilevel cervical canal stenosis (CCS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was conducted, and 93 patients who met inclusion and exclusion criteria in our hospital between 2015 and 2020 were followed for a minimum duration of 2\u2009years. Among them, 30 patients (Group A) received conservative treatment, 18 patients (Group B) received early surgery (\u22647\u2009days), and 45 patients (Group C) received late surgery (&gt;7\u2009days). The American Spinal Injury Association (ASIA) grade, Japanese Orthopedic Association (JOA) score, and recovery rate (RR) were evaluated. Multivariate linear regression was used to analyze prognostic determinants. Cost\u2010utility analysis was performed based on the EQ\u20105D scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The ASIA grade, JOA score, and RR of all three groups improved compared with the previous evaluation (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). During follow\u2010up, the ASIA grade, JOA score, and RR of Group B were all better than for Group A and Group C (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), while there was no significant difference between Group A and C (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). The EQ\u20105D scale in Group B was optimal at the last follow\u2010up. The incremental cost\u2010utility ratio (ICUR) of Group A was the lowest, while that of Group B compared to Group A was less than the threshold of patients\u2019 willingness to pay. Age, initial ASIA grade, and treatment types significantly affected the outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both conservative and surgical treatments yield good results. Compared with patients who received conservative treatment and late surgery, patients who received early surgery had better clinical function and living quality. Despite the higher cost, early surgery is cost\u2010effective when compared to conservative treatment. Younger age, initial better ASIA grade, and earlier surgery were associated with better prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13904","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T05:03:03Z","timestamp":1695963783000},"page":"3092-3100","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Benefits of Early Surgical Treatment for Patients with Multilevel Cervical Canal Stenosis of Acute Traumatic Central Cord Syndrome"],"prefix":"10.1111","volume":"15","author":[{"given":"Quan","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, The First Affiliated Hospital of Soochow University Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"He","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The First Affiliated Hospital of Soochow University Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaheng","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The First Affiliated Hospital of Soochow University Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The First Affiliated Hospital of Soochow University Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7435-4125","authenticated-orcid":false,"given":"Huilin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The First Affiliated Hospital of Soochow University Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junxin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The First Affiliated Hospital of Soochow University Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5450-6670","authenticated-orcid":false,"given":"Tao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The First Affiliated Hospital of Soochow University Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101893"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2021.03.007"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000000731"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuchi.2013.12.002"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2192568219830943"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.21.3.216"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1954.11.6.0546"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-021-02677-y"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3171\/FOC.2008.25.11.E9"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101944"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-22-00260"},{"issue":"1","key":"e_1_2_10_13_1","first-page":"25","article-title":"Traumatic central cord syndrome: results of surgical management","volume":"97","author":"Guest J","year":"2002","journal-title":"J Neurosurg"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surneu.2004.03.020"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.BRS.0000127186.81814.4A"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000004759"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0390-5616.21.05078-5"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.164.1.3588931"},{"key":"e_1_2_10_19_1","first-page":"407","article-title":"Guidelines for the management of acute cervical spine and spinal cord injuries","volume":"49","author":"Hadley MN","year":"2002","journal-title":"Clin Neurosurg"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000430319.32247.7f"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-019-06085-z"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-023-07626-3"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101627"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199811150-00007"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2014.05.007"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2010.00115"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.1996.129"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.82B6.0820851"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.4454"},{"issue":"2","key":"e_1_2_10_30_1","first-page":"323","article-title":"Immediate spinal cord decompression for cervical spinal cord injury: feasibility and outcome","volume":"52","author":"Papadopoulos SM","year":"2002","journal-title":"J Trauma"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20220907-07"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e318276f64b"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1735858"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2009.179"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30406-3"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000000946"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-022-07447-w"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-023-05698-0"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000001065"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2004.04.008"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.3171\/2015.1.SPINE141013"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.1996.111"},{"issue":"5","key":"e_1_2_10_43_1","first-page":"595","article-title":"Methylprednisolone in acute traumatic spinal cord injury: case\u2010matched outcomes from the NASCIS2 and Sygen historical spinal cord injury studies with contemporary statistical analysis","volume":"38","author":"Geisler FH","year":"2023","journal-title":"J Neurosurg Spine"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.13004\/kjnt.2022.18.e21"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.02.116"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217735804"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217703387"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2015.12.072"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(00)00176-5"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.3171\/2018.10.SPINE18802"},{"issue":"1","key":"e_1_2_10_51_1","first-page":"18","article-title":"Traumatic central cord syndrome: clinical features and functional outcomes","volume":"71","author":"Roth EJ","year":"1990","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.3171\/2008.9.SPI0822"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13904","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T08:22:10Z","timestamp":1702974130000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.13904"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,28]]},"references-count":51,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1111\/os.13904"],"URL":"https:\/\/doi.org\/10.1111\/os.13904","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,28]]},"assertion":[{"value":"2023-06-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}