{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T10:31:08Z","timestamp":1786357868478,"version":"build-2736575974"},"reference-count":80,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Traumatic spinal cord injury (SCI) is a catastrophic condition associated with profound neurologic disability, psychosocial disruption, high long-term healthcare utilization, and reduced life expectancy. Globally, SCI remains a major cause of morbidity, most commonly resulting from traumatic mechanisms such as motor vehicle collisions and falls, with a bimodal age distribution affecting both younger adults and older individuals. This narrative review provides a comprehensive, clinically oriented overview of SCIs with emphasis on classification, initial evaluation, imaging, and contemporary management strategies. The review highlights the dual-phase pathophysiology of SCIs\u2014primary mechanical insult followed by secondary injury cascades\u2014underscoring the rationale for rapid stabilization and timely, injury-specific interventions. Initial care is framed around immobilization and trauma resuscitation principles, with cervical spine clearance guided by validated decision tools and early, appropriate imaging acquisition. We discuss adjunctive imaging considerations and address the ongoing debate regarding MRI use in obtunded patients with negative initial studies. Acute inpatient management priorities include prevention of secondary complications, hemodynamic optimization, respiratory support, and vigilant surveillance for autonomic dysfunction. Pharmacologic neuroprotection with high-dose methylprednisolone remains controversial; current guideline recommendations are reviewed. Finally, we outline operative decision-making and evidence supporting early decompression in selected patients, as well as common surgical approaches and their indications. This review consolidates foundational concepts and current standards to support practical, evidence-informed SCI evaluation and management.<\/jats:p>","DOI":"10.3390\/jcm15166175","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T09:24:53Z","timestamp":1786353893000},"page":"6175","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Traumatic Spinal Cord Injury: A Contemporary Review of Classification, Evaluation, and Acute Management"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8916-1315","authenticated-orcid":false,"given":"John Carlos","family":"McDearman","sequence":"first","affiliation":[{"name":"Jack Hughston Memorial Hospital, 4401 Riverchase Dr., Phenix City, AL 36867, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Attelah","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Morehouse School of Medicine, 720 Westview Dr., Alanta, GA 30310, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Nourbakhsh","sequence":"additional","affiliation":[{"name":"OrthoAtlanta, 1240 Eagles Landing Pkwy, Stockbridge, GA 30281, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"National Spinal Cord Injury Statistical Center (2016). Spinal Cord Injury (SCI) 2016 Facts and Figures at a Glance. J. Spinal Cord Med., 39, 493\u2013494.","DOI":"10.1080\/10790268.2016.1210925"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1017\/S0317167100014530","article-title":"Global Incidence and Prevalence of Traumatic Spinal Cord Injury","volume":"40","author":"Furlan","year":"2013","journal-title":"Can. J. Neurol. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1177\/21925682211031190","article-title":"Direct Cost of Illness for Spinal Cord Injury: A Systematic Review","volume":"12","author":"Malekzadeh","year":"2022","journal-title":"Glob. Spine J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1080\/10790268.2017.1368267","article-title":"The Health Economics of the Spinal Cord Injury or Disease among Veterans of War: A Systematic Review","volume":"40","author":"Furlan","year":"2017","journal-title":"J. Spinal Cord Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1038\/sj.sc.3100501","article-title":"Causes and Costs of Spinal Cord Injury in the United States","volume":"35","author":"DeVivo","year":"1997","journal-title":"Spinal Cord"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1310\/sci1901-1","article-title":"Causes of Spinal Cord Injury","volume":"19","author":"Chen","year":"2013","journal-title":"Top. Spinal Cord Inj. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"100171","DOI":"10.1016\/j.wnsx.2023.100171","article-title":"Incidence of Traumatic Spinal Cord Injury Worldwide: A Systematic Review, Data Integration, and Update","volume":"18","author":"Jazayeri","year":"2023","journal-title":"World Neurosurg. X"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Wang, T.Y., Park, C., Zhang, H., Rahimpour, S., Murphy, K.R., Goodwin, C.R., Karikari, I.O., Than, K.D., Shaffrey, C.I., and Foster, N. (2021). Management of Acute Traumatic Spinal Cord Injury: A Review of the Literature. Front. Surg., 8.","DOI":"10.3389\/fsurg.2021.698736"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1038\/sc.1986.10","article-title":"Evaluation of Acute Surgical Intervention in Traumatic Paraplegia","volume":"24","author":"Wilmot","year":"1986","journal-title":"Spinal Cord"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"671","DOI":"10.2106\/00004623-199274050-00006","article-title":"Anterior Decompression and Arthrodesis of the Cervical Spine: Long-Term Motor Improvement. Part I--Improvement in Incomplete Traumatic Quadriparesis","volume":"74","author":"Bohlman","year":"1992","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.mporth.2020.06.002","article-title":"The Management of Traumatic Spinal Cord Injuries in Adults: A Review","volume":"34","author":"Copley","year":"2020","journal-title":"Orthop. Trauma"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"17018","DOI":"10.1038\/nrdp.2017.18","article-title":"Traumatic Spinal Cord Injury","volume":"3","author":"Ahuja","year":"2017","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2236","DOI":"10.1001\/jama.2015.6250","article-title":"Traumatic Spinal Cord Injury in the United States, 1993\u20132012","volume":"313","author":"Jain","year":"2015","journal-title":"JAMA"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.46292\/sci2702-1","article-title":"International Standards for Neurological Classification of Spinal Cord Injury: Revised 2019","volume":"27","author":"Rupp","year":"2021","journal-title":"Top. Spinal Cord Inj. Rehabil."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1038\/sc.1991.85","article-title":"Definition of Complete Spinal Cord Injury","volume":"29","author":"Waters","year":"1991","journal-title":"Spinal Cord"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1038\/sc.2013.180","article-title":"Epidemiology of Traumatic Spinal Cord Injuries in the Netherlands in 2010","volume":"52","author":"Nijendijk","year":"2014","journal-title":"Spinal Cord"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1097\/01.brs.0000207258.80129.03","article-title":"Epidemiology of Traumatic Spinal Cord Injury in Canada","volume":"31","author":"Pickett","year":"2006","journal-title":"Spine"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1016\/j.spinee.2015.04.041","article-title":"Spinal Cord Injury\u2014Incidence, Prognosis, and Outcome: An Analysis of the TraumaRegister DGU","volume":"15","author":"Stephan","year":"2015","journal-title":"Spine J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1111\/j.1468-1331.2006.01423.x","article-title":"Bowel Dysfunction in Patients with Cauda Equina Lesions","volume":"13","author":"Podnar","year":"2006","journal-title":"Eur. J. Neurol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1136\/jnnp.73.6.715","article-title":"Sexual Function in Men with Cauda Equina Lesions: A Clinical and Electromyographic Study","volume":"73","author":"Podnar","year":"2002","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1080\/10790268.2002.11753630","article-title":"Prevalence Of Upper Motor Neuron Vs Lower Motor Neuron Lesions In Complete Lower Thoracic And Lumbar Spinal Cord Injuries","volume":"25","author":"Doherty","year":"2002","journal-title":"J. Spinal Cord Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1002\/mus.20696","article-title":"Epidemiology of Cauda Equina and Conus Medullaris Lesions","volume":"35","author":"Podnar","year":"2007","journal-title":"Muscle Nerve"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/B978-0-444-52137-8.00003-6","article-title":"Clinical Diagnosis and Prognosis Following Spinal Cord Injury","volume":"109","author":"Burns","year":"2012","journal-title":"Handb. Clin. Neurol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/S0003-9993(99)90249-6","article-title":"Neurologic Recovery after Traumatic Spinal Cord Injury: Data from the Model Spinal Cord Injury Systems","volume":"80","author":"Marino","year":"1999","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1080\/10790268.2007.11753929","article-title":"Incidence and Outcomes of Spinal Cord Injury Clinical Syndromes","volume":"30","author":"McKinley","year":"2007","journal-title":"J. Spinal Cord Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S198","DOI":"10.1016\/j.spinee.2006.04.006","article-title":"Central Cord Injury: Pathophysiology, Management, and Outcomes","volume":"6","author":"Harrop","year":"2006","journal-title":"Spine J."},{"key":"ref_27","doi-asserted-by":"crossref","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":"ref_28","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1038\/sj.sc.3101944","article-title":"Neurological and Functional Outcome in Traumatic Central Cord Syndrome","volume":"45","author":"Aito","year":"2007","journal-title":"Spinal Cord"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"546","DOI":"10.3171\/jns.1954.11.6.0546","article-title":"The Syndrome of Acute Central Cervical Spinal Cord Injury: With Special Reference to the Mechanisms Involved in Hyperextension Injuries of Cervical Spine","volume":"11","author":"Schneider","year":"1954","journal-title":"J. Neurosurg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"935","DOI":"10.3171\/jns.1991.75.6.0935","article-title":"Decussation of Hind-Limb and Fore-Limb Fibers in the Monkey Corticospinal Tract: Relevance to Cruciate Paralysis","volume":"75","author":"Pappas","year":"1991","journal-title":"J. Neurosurg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/BF00588148","article-title":"Acute Traumatic Central Cord Syndrome: MRI-Pathological Correlations","volume":"34","author":"Quencer","year":"1992","journal-title":"Neuroradiology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"89S","DOI":"10.1177\/2192568219830943","article-title":"Management of Acute Traumatic Central Cord Syndrome: A Narrative Review","volume":"9","author":"Divi","year":"2019","journal-title":"Glob. Spine J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1080\/08998280.2015.11929201","article-title":"Anterior Spinal Cord Syndrome of Unknown Etiology","volume":"28","author":"Klakeel","year":"2015","journal-title":"Bayl. Univ. Med. Cent. Proc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1053\/j.sult.2016.05.002","article-title":"Spinal Cord Anatomy and Clinical Syndromes","volume":"37","author":"Diaz","year":"2016","journal-title":"Semin. Ultrasound CT MRI"},{"key":"ref_35","unstructured":"Pearl, N.A., Weisbrod, L.J., and Dubensky, L. (2026). Anterior Cord Syndrome (Archived). StatPearls, StatPearls Publishing."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1097\/00005792-198909000-00003","article-title":"Spinal Cord Infarction. Report of 8 Cases and Review of the Literature","volume":"68","author":"Sandson","year":"1989","journal-title":"Medicine"},{"key":"ref_37","first-page":"44","article-title":"A Population-Based Study of the Incidence of Acute Spinal Cord Infarction","volume":"9","author":"Qureshi","year":"2017","journal-title":"J. Vasc. Interv. Neurol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1212\/WNL.0b013e31823efc93","article-title":"Recovery after Spinal Cord Infarcts: Long-Term Outcome in 115 Patients","volume":"78","author":"Robertson","year":"2012","journal-title":"Neurology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1161\/01.STR.0000111598.78198.EC","article-title":"Long-Term Outcome of Acute Spinal Cord Ischemia Syndrome","volume":"35","author":"Nedeltchev","year":"2004","journal-title":"Stroke"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1227\/01.neu.0000318182.87664.1f","article-title":"CHARLES-\u00c9DOUARD BROWN-S\u00c9QUARD: AN ECCENTRIC GENIUS","volume":"62","author":"Rengachary","year":"2008","journal-title":"Neurosurgery"},{"key":"ref_41","unstructured":"Shams, S., Davidson, C.L., and Arain, A. (2026). Brown-S\u00e9quard Syndrome. StatPearls, StatPearls Publishing."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1038\/s41393-018-0225-5","article-title":"Epidemiology of Traumatic Spinal Cord Injury in Norway in 2012\u20132016: A Registry-Based Cross-Sectional Study","volume":"57","author":"Halvorsen","year":"2019","journal-title":"Spinal Cord"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"997","DOI":"10.2106\/00004623-200605000-00010","article-title":"Risk Factors for Respiratory Failure Following Operative Stabilization of Thoracic and Lumbar Spine Fractures","volume":"88","author":"McHenry","year":"2006","journal-title":"J. Bone Jt. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"52","DOI":"10.3171\/2012.6.AOSPINE1287","article-title":"What Do We Currently Know about Thoracic Spinal Cord Injury Recovery and Outcomes? A Systematic Review","volume":"17","author":"Bransford","year":"2012","journal-title":"J. Neurosurg. Spine"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1038\/sc.2010.140","article-title":"Characterization of Neurological Recovery Following Traumatic Sensorimotor Complete Thoracic Spinal Cord Injury","volume":"49","author":"Zariffa","year":"2011","journal-title":"Spinal Cord"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"384","DOI":"10.12968\/hmed.2005.66.7.18379","article-title":"Injuries to the Lumbar Spine: Identification and Management","volume":"66","author":"Woolard","year":"2005","journal-title":"Br. J. Hosp. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1080\/10400435.2015.1131759","article-title":"Redesign of a Spine Board: Proof of Concept Evaluation","volume":"28","author":"Nemunaitis","year":"2016","journal-title":"Assist. Technol."},{"key":"ref_48","unstructured":"(2017). Management of Acute Traumatic Spinal Cord Injuries. Handbook of Clinical Neurology, Elsevier."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1097\/TA.0000000000000153","article-title":"Pressure Ulcers from Spinal Immobilization in Trauma Patients: A Systematic Review","volume":"76","author":"Ham","year":"2014","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1302\/2058-5241.5.190047","article-title":"Cervical Spine Clearance after Blunt Trauma: Current State of the Art","volume":"5","author":"Moeri","year":"2020","journal-title":"EFORT Open Rev."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"S48","DOI":"10.1016\/j.jacr.2025.02.013","article-title":"ACR Appropriateness Criteria\u00ae Acute Spinal Trauma: 2024 Update","volume":"22","author":"Hassankhani","year":"2025","journal-title":"J. Am. Coll. Radiol."},{"key":"ref_52","first-page":"651","article-title":"Practice Management Guidelines for Identification of Cervical Spine Injuries Following Trauma: Update From the Eastern Association for the Surgery of Trauma Practice Management Guidelines Committee","volume":"67","author":"Como","year":"2009","journal-title":"J. Trauma Inj. Infect. Crit. Care"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.jcot.2017.06.012","article-title":"Imaging Investigations in Spine Trauma: The Value of Commonly Used Imaging Modalities and Emerging Imaging Modalities","volume":"8","author":"Tins","year":"2017","journal-title":"J. Clin. Orthop. Trauma"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1958","DOI":"10.1089\/neu.2014.3778","article-title":"Mean Arterial Blood Pressure Correlates with Neurological Recovery after Human Spinal Cord Injury: Analysis of High Frequency Physiologic Data","volume":"32","author":"Hawryluk","year":"2015","journal-title":"J. Neurotrauma"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"187S","DOI":"10.1177\/21925682231202348","article-title":"A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on Hemodynamic Management","volume":"14","author":"Kwon","year":"2024","journal-title":"Glob. Spine J."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1089\/neu.1990.7.113","article-title":"NASCIS","volume":"7","author":"Young","year":"1990","journal-title":"J. Neurotrauma"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1089\/neu.1992.9.151","article-title":"Rapid Quantification of Tissue Damage for Assessing Acute Spinal Cord Injury Therapy","volume":"9","author":"Young","year":"1992","journal-title":"J. Neurotrauma"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1097\/00132586-199808000-00011","article-title":"Administration of Methylprednisolone for 24 or 48 Hours or Tirilazad Mesylate for 48 Hours in the Treatment of Acute Spinal Cord Injury: Results of the Third National Acute Spinal Cord Injury Randomized Controlled Trial","volume":"42","author":"Bracken","year":"1998","journal-title":"Surv. Anesthesiol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1097\/00007632-200102150-00020","article-title":"Early Complications of High-Dose Methylprednisolone Sodium Succinate Treatment in the Follow-Up of Acute Cervical Spinal Cord Injury","volume":"26","author":"Matsumoto","year":"2001","journal-title":"Spine"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1038\/sj.sc.3100962","article-title":"Pharmacological Therapy of Spinal Cord Injury during the Acute Phase","volume":"38","author":"Pointillart","year":"2000","journal-title":"Spinal Cord"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"84S","DOI":"10.1177\/2192568217703387","article-title":"A Clinical Practice Guideline for the Management of Acute Spinal Cord Injury: Introduction, Rationale, and Scope","volume":"7","author":"Fehlings","year":"2017","journal-title":"Glob. Spine J."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1007\/s00264-003-0449-6","article-title":"Anterior Displacement Correlates with Neurological Impairment in Cervical Facet Dislocations","volume":"27","author":"McCormack","year":"2003","journal-title":"Int. Orthop. (SICOT)"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1038\/sc.1984.45","article-title":"Dislocations of the Cervical Spine: Closed Reduction under Anaesthesia","volume":"22","author":"Kleyn","year":"1984","journal-title":"Spinal Cord"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1302\/0301-620X.76B3.8175833","article-title":"Rapid Traction for Reduction of Cervical Spine Dislocations","volume":"76","author":"Lee","year":"1994","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"181","DOI":"10.14245\/ns.2244852.426","article-title":"Reduction of Lower Cervical Facet Dislocation: A Review of All Techniques","volume":"20","author":"Liu","year":"2023","journal-title":"Neurospine"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"737","DOI":"10.14245\/ns.2040368.184","article-title":"Subaxial Cervical Spine Injuries: WFNS Spine Committee Recommendations","volume":"17","author":"Sharif","year":"2020","journal-title":"Neurospine"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.jcot.2017.06.016","article-title":"Spinal Cord Injury-The Role of Surgical Treatment for Neurological Improvement","volume":"8","author":"Rath","year":"2017","journal-title":"J. Clin. Orthop. Trauma"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1177\/2192568219844990","article-title":"Complete Traumatic Spinal Cord Injury: Current Insights Regarding Timing of Surgery and Level of Injury","volume":"10","author":"Wengel","year":"2020","journal-title":"Glob. Spine J."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/S1474-4422(20)30406-3","article-title":"The Influence of Timing of Surgical Decompression for Acute Spinal Cord Injury: A Pooled Analysis of Individual Patient Data","volume":"20","author":"Badhiwala","year":"2021","journal-title":"Lancet Neurol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1089\/neu.2014.3632","article-title":"The Influence of Time from Injury to Surgery on Motor Recovery and Length of Hospital Stay in Acute Traumatic Spinal Cord Injury: An Observational Canadian Cohort Study","volume":"32","author":"Dvorak","year":"2015","journal-title":"J. Neurotrauma"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"The OSCIS Investigators, Chikuda, H., Koyama, Y., Matsubayashi, Y., Ogata, T., Ohtsu, H., Sugita, S., Sumitani, M., Kadono, Y., and Miura, T. (2021). Effect of Early vs Delayed Surgical Treatment on Motor Recovery in Incomplete Cervical Spinal Cord Injury With Preexisting Cervical Stenosis: A Randomized Clinical Trial. JAMA Netw. Open, 4, e2133604.","DOI":"10.1001\/jamanetworkopen.2021.33604"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1038\/s41394-018-0123-2","article-title":"Risk Factors for Spinal Cord Injury Progression after Anterior Fusion for Cervical Spine Trauma: A Retrospective Case-Control Study","volume":"4","author":"Okano","year":"2018","journal-title":"Spinal Cord Ser. Cases"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1097\/00024720-200306000-00001","article-title":"Comparison of Anterior and Posterior Approaches in Cervical Spinal Cord Injuries","volume":"16","author":"Brodke","year":"2003","journal-title":"J. Spinal Disord. Tech."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1016\/j.clineuro.2013.01.018","article-title":"Surgical Options in the Treatment of Subaxial Cervical Fractures: A Retrospective Cohort Study","volume":"115","author":"Belirgen","year":"2013","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"689","DOI":"10.14245\/ns.2244616.308","article-title":"Surgical Considerations to Improve Recovery in Acute Spinal Cord Injury","volume":"19","author":"Tabarestani","year":"2022","journal-title":"Neurospine"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"10346","DOI":"10.1038\/s41598-020-67265-2","article-title":"Comparison of Anterior and Posterior Approaches for Treatment of Traumatic Cervical Dislocation Combined with Spinal Cord Injury: Minimum 10-Year Follow-Up","volume":"10","author":"Ren","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"E188","DOI":"10.1097\/01.brs.0000257577.70576.07","article-title":"Stabilizing Potential of Anterior, Posterior, and Circumferential Fixation for Multilevel Cervical Arthrodesis: An In Vitro Human Cadaveric Study of the Operative and Adjacent Segment Kinematics","volume":"32","author":"Dmitriev","year":"2007","journal-title":"Spine"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/00007632-200101010-00005","article-title":"A Biomechanical Comparison of Modern Anterior and Posterior Plate Fixation of the Cervical Spine","volume":"26","author":"Lim","year":"2001","journal-title":"Spine"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"108","DOI":"10.3171\/spi.2004.1.1.0108","article-title":"A Biomechanical Comparison of Three Surgical Approaches in Bilateral Subaxial Cervical Facet Dislocation","volume":"1","author":"Kim","year":"2004","journal-title":"J. Neurosurg. Spine"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/SPI-07\/07\/001","article-title":"A Prospective Randomized Controlled Trial of Anterior Compared with Posterior Stabilization for Unilateral Facet Injuries of the Cervical Spine","volume":"7","author":"Kwon","year":"2007","journal-title":"J. Neurosurg. 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