A Review of Strategies Associated with Surgical Decompression in Traumatic Spinal Cord Injury

Abstract

Traumatic spinal cord injury (TSCI) is a common catastrophic disease. Timely diagnosis and treatment by nursing professional have reduced the mortality, but the long-term recovery of neurological functions remains ominous. After the occurrence of TSCI, tissue bleeding, edema and spinal dural binding leads to increase in internal pressure of spinal canal and spinal cord parenchyma, further causing the pathophysiological processes of ischemia and hypoxia, eventually accelerating the cascade of secondary spinal cord injury. Reasonable surgery time with appropriate surgical decompression strategies can reduce the associated secondary injury. However, disagreement about the safety and effectiveness of decompression surgery and the timing of surgery still exist. The level and severity of nerve injury does have impact on the timing of surgery, therefore clinical TSCI subsets may benefit from early surgery. Early surgery perhaps has little effect on recovery from complete TSCI, but relatively improves in patients with incomplete injury. Early decompression should be considered in patients with incomplete cervical TSCI. Patient age should not be used as an exclusion criterion for early surgery. The best time point for early surgery should not be limited by advances, but should also be defined by the shortest duration to thoroughly examine the patient's condition and stabilize the patient's state. After adequate assessment of the patient's condition, a promising emergency myelotomy decompression style is feasible. Therefore, number of conditions should be considered, such as standardized decompression methods, indications and operation timing to ensure the effectiveness and safety of early surgical intervention, promotion of the functional recovery of residual nerve tissue.