{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T01:23:51Z","timestamp":1791768231928,"version":"4.3.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"3_suppl","license":[{"start":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T00:00:00Z","timestamp":1504224000000},"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":["Global Spine Journal"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To develop recommendations on the timing of surgical decompression in patients with traumatic spinal cord injury (SCI) and central cord syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic review of the literature was conducted to address key relevant questions. A multidisciplinary guideline development group used this information, along with their clinical expertise, to develop recommendations for the timing of surgical decompression in patients with SCI and central cord syndrome. Based on GRADE, a strong recommendation is worded as \u201cwe recommend,\u201d whereas a weak recommendation is presented as \u201cwe suggest.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Conclusions from the systematic review included (1) isolated studies reported statistically significant and clinically important improvements following early decompression at 6 months and following discharge from inpatient rehabilitation; (2) in one study on acute central cord syndrome without instability, a marginally significant improvement in total motor scores was reported at 6 and 12 months in patients managed with early versus late surgery; and (3) there were no significant differences in length of acute care\/rehabilitation stay or in rates of complications between treatment groups. Our recommendations were: \u201cWe suggest that early surgery be considered as a treatment option in adult patients with traumatic central cord syndrome\u201d and \u201cWe suggest that early surgery be offered as an option for adult acute SCI patients regardless of level.\u201d Quality of evidence for both recommendations was considered low.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>These guidelines should be implemented into clinical practice to improve outcomes in patients with acute SCI and central cord syndrome by promoting standardization of care, decreasing the heterogeneity of management strategies, and encouraging clinicians to make evidence-informed decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2192568217706367","type":"journal-article","created":{"date-parts":[[2017,9,5]],"date-time":"2017-09-05T11:04:01Z","timestamp":1504609441000},"page":"195S-202S","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":232,"title":["A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury and Central Cord Syndrome: Recommendations on the Timing (\u226424 Hours Versus &gt;24 Hours) of Decompressive Surgery"],"prefix":"10.1177","volume":"7","author":[{"given":"Michael G.","family":"Fehlings","sequence":"first","affiliation":[{"name":"Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada"},{"name":"University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay A.","family":"Tetreault","sequence":"additional","affiliation":[{"name":"Toronto Western Hospital, University Health Network, 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University of Kansas, Kansas City, KS, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anoushka","family":"Singh","sequence":"additional","affiliation":[{"name":"Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea C.","family":"Skelly","sequence":"additional","affiliation":[{"name":"Spectrum Research, Inc, Tacoma, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eve C.","family":"Tsai","sequence":"additional","affiliation":[{"name":"University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Vaccaro","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Jefferson Health, Thomas Jefferson University, Philadelphia, PA, 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