{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:05:19Z","timestamp":1793318719513,"version":"4.5.0"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"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"],"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Propensity score-matched retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine whether early cervical decompression is associated with in-hospital pulmonary embolism (PE) after traumatic cervical spinal cord injury (SCI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults with traumatic cervical SCI undergoing coded cervical decompression after direct admission were identified in the National Trauma Data Bank, 2019 to 2024. Early decompression was within 24 hours; delayed decompression was after 24 hours. Patients were matched 1:1 using 30 covariates. The primary outcome was detected in-hospital PE. Robustness analyses included sensitivity, subgroup, landmark, negative-control, competing-risk, clustered-error, bootstrap, and McNemar analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 11,530 decompression-coded patients, matching yielded 4,480 balanced pairs. Early decompression was not associated with detected PE (OR 0.97, 95% CI 0.70 to 1.35; p = 0.868; absolute risk difference \u22120.04%, 95% CI \u22120.58% to 0.49%). Robustness analyses supported this null finding, including a null negative-control outcome (OR 1.10, 95% CI 0.75 to 1.62). No subgroup interaction was significant after multiplicity correction. In patients with Injury Severity Score \u226525, PE risk was similar (OR 0.88, 95% CI 0.56 to 1.39). Early decompression was associated with higher in-hospital mortality overall (OR 1.54, 95% CI 1.30 to 1.82), creating potential competing-risk bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early cervical decompression after traumatic cervical SCI was not associated with increased detected in-hospital PE. PE risk alone should not justify delaying otherwise indicated decompression, but differential mortality and residual confounding require cautious interpretation and prospective confirmation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261474150","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T20:53:54Z","timestamp":1785185634000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Early Surgical Decompression and Pulmonary Embolism Risk in Traumatic Cervical Spinal Cord Injury: A Propensity Score-Matched National Analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9897-4071","authenticated-orcid":false,"given":"Samer G.","family":"Salman","sequence":"first","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8611-6711","authenticated-orcid":false,"given":"Rohan A.","family":"Phadke","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Rush University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"Best Practices Guidelines: Spine Injury","author":"Schroeder GD","year":"2022","unstructured":"Schroeder GD, Vaccaro AR, Welch WC, et al. 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