Operative and nonoperative management of spinal cord injury. A review

Outcome of decompression surgery for cervical spinal cord injury without bone and disc injury in patients with spinal cord compression: a multicenter prospective study

“…The mean period from injury to operation was 8.2 days (range [3][4][5][6][7][8][9][10][11][12][13][14]. Sixteen cases were treated by laminoplasty, and only one case by anterior decompression and spinal fusion.…”

“…The terminology regarding this type of injury remains confusing whereas, in addition, treatment with either surgery or conservative measures remains controversial. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Such cervical cord injury has previously been called 'Adult SCIWORA (Spinal cord injury without radiographic abnormality in adults, 10 or Spinal cord injury without radiological abnormality in adults 19 )'. However, this term is incorrect because the terminology 'SCIWORA (Spinal cord injury without radiographic abnormality)' was created before the development of computed tomography and magnetic resonance imaging (MRI), and only for children.…”

“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] This injury does not usually require surgery for the reconstruction of the spinal column but instead may require decompression for the narrowed spinal canal with laminoplasty, to achieve an improvement in the paralysis. Some surgeons have reported an improvement of paralysis, following decompression of the spinal cord, whereas others have concluded that the fate of an injured spinal cord cannot change by decompression surgery, as such spinal cord compression may have existed before the injury even though such patients had been asymptomatic.…”

Spinal Cord Injury-Past, Present, and Future

“…The former favored operating on the injured spinal cord, arguing that since death was inevitable anyway without surgery, nothing was to be lost. The latter posited that surgery only increased the risk of death and could further damage nerve fibers with any potential to improve (9).…”

“…The Spine. As noted, instruments and techniques now exist to assure spinal stability, obtain reductions, maintain alignment, and thereby avoid the pain and further disability caused by a deformed spine (9). In addition, imaging capabilities have expanded significantly, not only with respect to the ability to correlate MRI with impairment (50,51) and prognosis (52,53), but with new MRI applications such as magnetic resonance imagingdiffusion weighted imaging (54,55), which allows imaging of the tracts within the spinal cord; functional MRI (56,57); and MRI spectroscopy (58,59).…”