Early decompression (< 8 hours) improves the functional bladder outcome and mobility after traumatic thoracic spinal cord injury

Abstract Object There is accumulating evidence of a potential beneficial effect of early surgical intervention after acute cervical spinal cord injury (SCI). However, around one third of all SCI affect the thoracic spine. This cohort has not been extensively investigated – mainly due to less sensitive clinical readout measures. Apart from regaining full sensorimotor function, improvements in bladder and bowel management remain of the highest priority for chronic paraplegic patients. Therefore, this study investigates the effect of early decompression (here defined as Methods We retrospectively analyzed data from the institutional database, in which follow-up data was collected prospectively according to the EMSCI (European Multicenter Study about Spinal Cord Injury) standards. Within a 13-year period, we identified 43 patients who met in- and exclusion criteria. 32 (74%) were managed surgically within the first 8 hours. There was a trend towards a higher rate of clinically complete SCI patients in the early group at baseline. Results : After 1 year, we did not observe a benefit on the neurological outcome as assessed via the AIS score (American Spinal Injury Association Impairment Scale). Functional outcome was evaluated using the SCIM (Spinal Cord Independence Measure). The early decompressed group demonstrated significantly improved SCIM-6 (i.e. bladder management) (p Conclusion Early decompression was an independent predictor for improved functional bladder outcome and mobility after 1 year. This effect needs to be studied in future prospective, multi-center studies.