{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T11:58:16Z","timestamp":1793447896908,"version":"4.5.0"},"reference-count":40,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>This systematic review and meta-analysis aimed to evaluate the impact of surgical timing on neurological and functional outcomes in patients with traumatic spinal cord injury (TSCI).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>A comprehensive literature search was conducted in PUBMED and ScienceDirect databases for studies published between 2015 and 2025, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies comparing surgical timing (\u226412 h, \u226424 h, and &gt;24 h) were included.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>A total of 22 comparative studies comprising 2,395 patients were included. Among them, 346 underwent ultra-early decompression (\u226412 h), 1,140 underwent early surgery (\u226424 h), and 908 underwent delayed surgery (&gt;24 h). Ultra-early surgery (\u226412 h) significantly improved neurological outcomes compared to surgery after 12 h (odds ratio [OR] 2.30; 95% confidence interval [CI]: 1.69\u20133.14; <jats:italic>P<\/jats:italic> &lt; 0.00001). Surgery within 24 h also outperformed surgery after 24 h (OR 1.49; 95% CI: 1.19\u20131.87; <jats:italic>P<\/jats:italic> &lt; 0.0005). While the American Spinal Injury Association motor scores at 6 months were not significantly different (mean difference [MD] \u22123.30; 95% CI: \u22128.24\u20131.65; <jats:italic>P<\/jats:italic> = 0.19), scores at 1 year significantly favored the \u226424-h group (MD 4.90; 95% CI: 2.84\u20136.95; <jats:italic>P<\/jats:italic> &lt; 0.00001). Early surgery reduced hospital stay duration (MD \u22124.94; 95% CI: \u22129.69\u2013\u22120.20; <jats:italic>P<\/jats:italic> = 0.04), with no significant differences in mortality or major complications.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Surgical decompression within 24 h, especially within 12 h, is associated with significantly better neurological recovery, improved long-term motor outcomes, and shorter hospitalization, without increased mortality or major complications. These findings underscore the critical role of timely surgical intervention in acute TSCI management.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_678_2025","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T08:14:56Z","timestamp":1756455296000},"page":"368","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluating the role of surgical timing on clinical outcomes in traumatic spinal cord injury: A systematic review and meta-analysis"],"prefix":"10.25259","volume":"16","author":[{"given":"Tommy Alfandy","family":"Nazwar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhad","family":"Bal\u2019afif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donny Wisnu","family":"Wardhana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fachriy","family":"Bal\u2019afif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christin","family":"Panjaitan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"10.25259\/SNI_678_2025\/ref-1","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1089\/neu.2021.0040","article-title":"Efficacy of early (\u2264 24 hours), late (25-72 hours), and delayed (>72 hours) surgery with magnetic resonance imaging-confirmed decompression in American spinal injury association impairment scale grades C and D acute traumatic central cord syndrome caused by spinal stenosis","volume":"38","author":"Aarabi","year":"2021","journal-title":"J 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