Under pressure - A historical vignette on surgical timing in traumatic spinal cord injury

Introduction: It was not even a century ago when a spinal cord injury (SCI) would inevitably result in a fatal outcome, particularly for those with complete SCI. Throughout history, there have been extensive endeavours to change the prospects for SCI patients by performing surgery, even though many...

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Main Authors: Paula Valerie ter Wengel, Florence Reith, Charlotte Y. Adegeest, Michael G. Fehlings, Brian K. Kwon, W. Peter Vandertop, Cumhur F. Öner
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Brain and Spine
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Online Access:http://www.sciencedirect.com/science/article/pii/S277252942400081X
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author Paula Valerie ter Wengel
Florence Reith
Charlotte Y. Adegeest
Michael G. Fehlings
Brian K. Kwon
W. Peter Vandertop
Cumhur F. Öner
author_facet Paula Valerie ter Wengel
Florence Reith
Charlotte Y. Adegeest
Michael G. Fehlings
Brian K. Kwon
W. Peter Vandertop
Cumhur F. Öner
author_sort Paula Valerie ter Wengel
collection DOAJ
description Introduction: It was not even a century ago when a spinal cord injury (SCI) would inevitably result in a fatal outcome, particularly for those with complete SCI. Throughout history, there have been extensive endeavours to change the prospects for SCI patients by performing surgery, even though many believed that there was no way to alter the catastrophic course of SCI. To this day, the debate regarding the efficacy of surgery in improving the neurological outcome for SCI patients persists, along with discussions about the timing of surgical intervention. Research question: How have the historical surgical results shaped our perspective on the surgical treatment of SCI? Material and methods: Narrative literature review. Results: Throughout history there have been multiple surgical attempts to alter the course of SCI, with conflicting results. While studies suggest a potential link between timing of surgery and neurological recovery, the exact impact of immediate surgery on individual cases remains ambiguous. It is becoming more evident that, alongside surgical intervention, factors specific to both the patient and their surgical treatment will significantly influence neurological recovery. Conclusion: Although a growing number of studies indicates a potential correlation of surgical timing and neurological outcome, the precise influence of urgent surgery on an individual basis remains uncertain. It is increasingly apparent that, despite surgery, patient- and treatment-specific factors will also play a role in determining the neurological outcome. Notably, these very factors have influenced the results in previous studies and our views concerning surgical timing.
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spelling doaj-art-77b3400e94e342849eef7bb3ed1e971c2024-12-15T06:18:26ZengElsevierBrain and Spine2772-52942024-01-014102825Under pressure - A historical vignette on surgical timing in traumatic spinal cord injuryPaula Valerie ter Wengel0Florence Reith1Charlotte Y. Adegeest2Michael G. Fehlings3Brian K. Kwon4W. Peter Vandertop5Cumhur F. Öner6Department of Neurosurgery, Haaglanden Medical Center, the Hague, the Netherlands; Corresponding author. Department of Neurosurgery, Haaglanden Medical Center, Lijnbaan 32, 2512 VA, the Hague, the Netherlands.Department of Neurosurgery, Northwest Clinics, Alkmaar, the NetherlandsDepartment of Neurosurgery, Haaglanden Medical Center, the Hague, the Netherlands; Department of Neurosurgery, Leiden University Medical Center, Leiden, the NetherlandsDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, CanadaDepartment of Orthopaedics, University of British Columbia, Vancouver, CanadaDepartment of Neurosurgery, Amsterdam University Medical Center, Amsterdam, the NetherlandsDepartment of Orthopedic Surgery, University Medical Center, Utrecht, the NetherlandsIntroduction: It was not even a century ago when a spinal cord injury (SCI) would inevitably result in a fatal outcome, particularly for those with complete SCI. Throughout history, there have been extensive endeavours to change the prospects for SCI patients by performing surgery, even though many believed that there was no way to alter the catastrophic course of SCI. To this day, the debate regarding the efficacy of surgery in improving the neurological outcome for SCI patients persists, along with discussions about the timing of surgical intervention. Research question: How have the historical surgical results shaped our perspective on the surgical treatment of SCI? Material and methods: Narrative literature review. Results: Throughout history there have been multiple surgical attempts to alter the course of SCI, with conflicting results. While studies suggest a potential link between timing of surgery and neurological recovery, the exact impact of immediate surgery on individual cases remains ambiguous. It is becoming more evident that, alongside surgical intervention, factors specific to both the patient and their surgical treatment will significantly influence neurological recovery. Conclusion: Although a growing number of studies indicates a potential correlation of surgical timing and neurological outcome, the precise influence of urgent surgery on an individual basis remains uncertain. It is increasingly apparent that, despite surgery, patient- and treatment-specific factors will also play a role in determining the neurological outcome. Notably, these very factors have influenced the results in previous studies and our views concerning surgical timing.http://www.sciencedirect.com/science/article/pii/S277252942400081XSpinal cord injurySurgeryTimingHistoryManagement
spellingShingle Paula Valerie ter Wengel
Florence Reith
Charlotte Y. Adegeest
Michael G. Fehlings
Brian K. Kwon
W. Peter Vandertop
Cumhur F. Öner
Under pressure - A historical vignette on surgical timing in traumatic spinal cord injury
Brain and Spine
Spinal cord injury
Surgery
Timing
History
Management
title Under pressure - A historical vignette on surgical timing in traumatic spinal cord injury
title_full Under pressure - A historical vignette on surgical timing in traumatic spinal cord injury
title_fullStr Under pressure - A historical vignette on surgical timing in traumatic spinal cord injury
title_full_unstemmed Under pressure - A historical vignette on surgical timing in traumatic spinal cord injury
title_short Under pressure - A historical vignette on surgical timing in traumatic spinal cord injury
title_sort under pressure a historical vignette on surgical timing in traumatic spinal cord injury
topic Spinal cord injury
Surgery
Timing
History
Management
url http://www.sciencedirect.com/science/article/pii/S277252942400081X
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