{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T03:46:04Z","timestamp":1774410364833,"version":"3.50.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Spinal cord injury (SCI) can be caused by a variety of factors and its severity can range from a mild concussion to a complete severing of the spinal cord. \u03a4reatment depends on the type and severity of injury, the patient\u2019s age and overall health. Reduction of dislocated or fractured vertebrae via closed manipulation or surgical procedures, fixation and removal of bony fragments and debris that compromise the spinal canal are indicated for decompression of the spinal cord and stabilization of the spine. However, when there is no obvious traumatic obstruction of spinal canal, the question arises as to whether laminectomy is needed to be performed to improve neurological outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A literature review covering all indexed studies published between 2013 and 2023 was performed using keywords to identify the patient group of interest (spinal cord injury, SCI, spinal cord trauma, cervical, thoracic, lumbar, thoracolumbar),central cord syndrome (CCS) and the interventions (laminectomy, laminoplasty, decompression, duroplasty).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This review includes6 observational studies investigating the outcome of posterior spinal decompression in patients suffering from spinal cord injury without traumatic spinal cord stenosis. Most patients already had degenerative stenosis. From a total of 202, 151 patients (74.7%) improved neurologically by at least one grade at ASIA scale, after being treated with either laminectomy, laminoplasty, duroplasty or a combination of these techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early decompression in SCI patients remains a reasonable practice option and can be performed safely, but no specific evidence supports the use of laminectomy alone. There is emerging evidence that intended durotomy followed by extended meningoplasty may improve the neurological outcome in patients suffering from SCI when meta-traumatic edema is apparent. However, the lack of high-quality evidence and results support the need for further research.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1220598","type":"journal-article","created":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T07:00:23Z","timestamp":1695020423000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Posterior spinal decompression in adults with spinal cord injury without traumatic compromise of the spinal canal: what is the data?"],"prefix":"10.3389","volume":"14","author":[{"given":"Mary","family":"Solou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasios A.","family":"Politis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u0399oannis","family":"Ydreos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evangelos K.","family":"Papadopoulos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stamatios","family":"Banos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Savvanis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria M.","family":"Gavra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Efstathios J.","family":"Boviatsis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lampis C.","family":"Stavrinou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"133","DOI":"10.14245\/kjs.2013.10.3.133","article-title":"Neurologic outcome of laminoplasty for acute traumatic spinal cord injury without instability","volume":"10","author":"Lee","year":"2013","journal-title":"Korean J Spine"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"698736","DOI":"10.3389\/fsurg.2021.698736","article-title":"Management of acute traumatic spinal cord injury: a review of the literature","volume":"8","author":"Wang","year":"2021","journal-title":"Front Surg"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1055\/a-1811-8201","article-title":"A review of strategies associated with surgical decompression in traumatic spinal cord injury","author":"Zhu","year":"2023","journal-title":"J Neurol Surg A Cent Eur Neurosurg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"618","DOI":"10.2106\/JBJS.17.00811","article-title":"Controversies in the management of central cord syndrome: the state of the art","volume":"100","author":"Wagner","year":"2018","journal-title":"J Bone Joint Surg AM"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2275","DOI":"10.1007\/s00586-019-06091-1","article-title":"Early durotomy with duroplasty for severe adult spinal cord injury without radiographic abnormality: a novel concept and method of surgical decompression","volume":"28","author":"Zhu","year":"2019","journal-title":"Eur Spine"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"71","DOI":"10.3233\/BMR-210377","article-title":"Effectiveness of different surgical methods in the treatment of acute central cord syndrome without fractures and dislocations of the cervical spine","volume":"36","author":"Jia","year":"2023","journal-title":"J Back Musculoskelet Rehabil"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1590\/0004-282X20170048","article-title":"Traumatic spinal cord injury: current concepts and treatment update","volume":"75","author":"Rouanet","year":"2017","journal-title":"Arq Neuropsiquiatr"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"282","DOI":"10.4103\/1793-5482.175638","article-title":"Outcome of laminoplasty in cervical spinal cord injury with stable spine","volume":"11","author":"Ghasemi","year":"2016","journal-title":"Asian J Neurosurg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1401","DOI":"10.1007\/s00402-013-1810-x","article-title":"Does laminoplasty really improve neurological status in patients with cervical spinal cord injury without bone and disc injury? A prospective study about neurological recovery and early complications","volume":"133","author":"Mazaki","year":"2013","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1136\/bmj.n71","article-title":"Statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2020","journal-title":"BMJ"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan \u2014 a web and mobile app for systematic reviews","volume":"5","author":"Mourad","year":"2016","journal-title":"Syst Rev"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1007\/s11999-016-5133-4","article-title":"Classifications in brief: American spinal injury association (ASIA) impairment scale","volume":"475","author":"Roberts","year":"2017","journal-title":"Clin Orthop Relat Res"},{"key":"ref13","volume-title":"DATAtab: online statistics calculator","year":"2023"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1089\/neu.2014.3668","article-title":"Expansion duroplasty improves intraspinal pressure, spinal cord perfusion pressure, and vascular pressure reactivity index in patients with traumatic spinal cord injury: injured spinal cord pressure evaluation study","volume":"32","author":"Phang","year":"2015","journal-title":"J Neurotrauma"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1016\/j.nec.2021.03.008","article-title":"Acute, severe traumatic spinal cord injury: monitoring from the injury site and expansion duraplasty","volume":"32","author":"Saadoun","year":"2021","journal-title":"Neurosurg Clin N Am"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"629445","DOI":"10.3389\/fneur.2021.629445","article-title":"Acute traumatic spinal cord injury in humans, dogs, and other mammals: the under-appreciated role of the dura","volume":"12","author":"Saadoun","year":"2021","journal-title":"Front Neurol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.neuchi.2013.12.002","article-title":"Acute traumatic central cord syndrome: a comprehensive review","volume":"60","author":"Molliqaj","year":"2014","journal-title":"Neurochirurgie"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1024\/1661-8157\/a003659","article-title":"Acute traumatic central cord syndrome: etiology, pathophysiology, clinical manifestation, and treatment","volume":"110","author":"Tosic","year":"2021","journal-title":"Praxis"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"448","DOI":"10.4055\/cios.2018.10.4.448","article-title":"The importance of early surgical decompression for acute traumatic spinal cord injury","volume":"10","author":"Lee","year":"2018","journal-title":"Clin Orthop Surg"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"984899","DOI":"10.3389\/fsurg.2022.984899","article-title":"Early expansive single sided laminoplasty decompression treatment severe traumatic cervical spinal cord injury","volume":"9","author":"Yang","year":"2022","journal-title":"Front Surg"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.1016\/j.otsr.2014.06.024","article-title":"Management of thoracolumbar spine fractures with neurologic disorder","volume":"101","author":"Charles","year":"2015","journal-title":"Orthop Traumatol Surg Res"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"582","DOI":"10.3109\/02688697.2016.1173191","article-title":"The dura causes spinal cord compression after spinal cord injury","volume":"30","author":"Saadoun","year":"2016","journal-title":"Br J Neurosurg"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1089\/neu.2017.5215","article-title":"Spinal meninges and their role in spinal cord injury: a neuroanatomical review","volume":"35","author":"Grassner","year":"2018","journal-title":"J Neurotrauma"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.wneu.2016.12.005","article-title":"Cervical spinal cord injury without computed tomography evidence of trauma in adults: magnetic resonance imaging prognostic factors","volume":"99","author":"Martinez-Perez","year":"2017","journal-title":"World Neurosurg"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1038\/sc.2015.45","article-title":"Early MRI finding in adult spinal cord injury without radiologic abnormalities does not correlate with the neurological outcome: a retrospective study","volume":"53","author":"Liu","year":"2015","journal-title":"Spinal Cord"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"E981","DOI":"10.1097\/BRS.0000000000001505","article-title":"Delayed magnetic resonance imaging in patients with cervical spinal cord injury without radiographic abnormality","volume":"41","author":"Ouchida","year":"2016","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"7060654","DOI":"10.1155\/2018\/7060654","article-title":"Posttraumatic spinal cord injury without radiographic abnormality","volume":"2018","author":"Atesok","year":"2018","journal-title":"Adv Orthop"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"3051","DOI":"10.1089\/neu.2016.4706","article-title":"Recurrent neurological deterioration after conservative treatment for acute traumatic central cord syndrome without bony injury: seventeen operative case reports","volume":"34","author":"Jin","year":"2017","journal-title":"J Neurotrauma"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"101507","DOI":"10.1016\/j.inat.2022.101507","article-title":"Impact of timing of surgery on traumatic central cord syndrome without fracture or dislocation","volume":"28","author":"Qin","year":"2022","journal-title":"Interdiscip Neurosurg"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"683","DOI":"10.3171\/2018.10.SPINE18802","article-title":"Neurological recovery following traumatic spinal cord injury: a systematic review and meta-analysis","volume":"30","author":"Khorasanizadeh","year":"2019","journal-title":"J Neurosurg Spine"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1186\/s12891-021-04297-3","article-title":"Laminoplasty with selective fusion at unstable segment versus laminectomy with fusion for multilevel cervical myelopathy: a case-control study","volume":"22","author":"Du","year":"2021","journal-title":"BMC Musculoskelet Disord"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"461","DOI":"10.12659\/PJR.890944","article-title":"Spinal cord injury without radiographic abnormality (SCIWORA) \u2013 clinical and radiological aspects","volume":"79","author":"Szwedowski","year":"2014","journal-title":"Pol J Radiol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1097\/TA.0b013e318265cd8c","article-title":"The misapplication of the term spinal cord injury without radiographic abnormality (SCIWORA) in adults","volume":"73","author":"Como","year":"2012","journal-title":"J Trauma Acute Care Surg"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1220598\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T07:00:28Z","timestamp":1695020428000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1220598\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,15]]},"references-count":33,"alternative-id":["10.3389\/fneur.2023.1220598"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2023.1220598","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,15]]},"article-number":"1220598"}}