Early Decompression following Cervical Spinal Cord Injury: Examining the Process of Care from Accident Scene to Surgery.

Battistuzzo, CR; Armstrong, A; Clark, J; Worley, L; Sharwood, L; Lin, P; Rooke, G; Skeers, P; Nolan, S; Geraghty, T; Nunn, A; Brown, DJ; Hill, S; Alexander, J; Millard, M; Cox, SF; Rao, S; Watts, A; Goods, L; Allison, GT; Agostinello, J; Cameron, PA; Mosley, I; Liew, SM; Geddes, T; Middleton, J; Buchanan, J; Rosenfeld, JV; Bernard, S; Atresh, S; Patel, A; Schouten, R; Freeman, BJC; Dunlop, SA; Batchelor, PE

Early Decompression following Cervical Spinal Cord Injury: Examining the Process of Care from Accident Scene to Surgery.

Battistuzzo, CR Armstrong, A Clark, J Worley, L Sharwood, L

Lin, P Rooke, G Skeers, P Nolan, S Geraghty, T Nunn, A Brown, DJ Hill, S Alexander, J Millard, M Cox, SF Rao, S Watts, A Goods, L Allison, GT Agostinello, J Cameron, PA Mosley, I Liew, SM Geddes, T Middleton, J Buchanan, J Rosenfeld, JV Bernard, S Atresh, S Patel, A Schouten, R Freeman, BJC Dunlop, SA Batchelor, PE

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Publisher:: MARY ANN LIEBERT, INC
Publication Type:: Journal Article
Citation:: J Neurotrauma, 2016, 33, (12), pp. 1161-1169
Issue Date:: 2016-06-15

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Field	Value	Language
dc.contributor.author	Battistuzzo, CR
dc.contributor.author	Armstrong, A
dc.contributor.author	Clark, J
dc.contributor.author	Worley, L
dc.contributor.author	Sharwood, L https://orcid.org/0000-0001-8977-6144
dc.contributor.author	Lin, P
dc.contributor.author	Rooke, G
dc.contributor.author	Skeers, P
dc.contributor.author	Nolan, S
dc.contributor.author	Geraghty, T
dc.contributor.author	Nunn, A
dc.contributor.author	Brown, DJ
dc.contributor.author	Hill, S
dc.contributor.author	Alexander, J
dc.contributor.author	Millard, M
dc.contributor.author	Cox, SF
dc.contributor.author	Rao, S
dc.contributor.author	Watts, A
dc.contributor.author	Goods, L
dc.contributor.author	Allison, GT
dc.contributor.author	Agostinello, J
dc.contributor.author	Cameron, PA
dc.contributor.author	Mosley, I
dc.contributor.author	Liew, SM
dc.contributor.author	Geddes, T
dc.contributor.author	Middleton, J
dc.contributor.author	Buchanan, J
dc.contributor.author	Rosenfeld, JV
dc.contributor.author	Bernard, S
dc.contributor.author	Atresh, S
dc.contributor.author	Patel, A
dc.contributor.author	Schouten, R
dc.contributor.author	Freeman, BJC
dc.contributor.author	Dunlop, SA
dc.contributor.author	Batchelor, PE
dc.date.accessioned	2023-02-15T21:19:54Z
dc.date.available	2023-02-15T21:19:54Z
dc.date.issued	2016-06-15
dc.identifier.citation	J Neurotrauma, 2016, 33, (12), pp. 1161-1169
dc.identifier.issn	0897-7151
dc.identifier.issn	1557-9042
dc.identifier.uri	http://hdl.handle.net/10453/166172
dc.description.abstract	Early decompression may improve neurological outcome after spinal cord injury (SCI), but is often difficult to achieve because of logistical issues. The aims of this study were to 1) determine the time to decompression in cases of isolated cervical SCI in Australia and New Zealand and 2) determine where substantial delays occur as patients move from the accident scene to surgery. Data were extracted from medical records of patients aged 15-70 years with C3-T1 traumatic SCI between 2010 and 2013. A total of 192 patients were included. The median time from accident scene to decompression was 21 h, with the fastest times associated with closed reduction (6 h). A significant decrease in the time to decompression occurred from 2010 (31 h) to 2013 (19 h, p = 0.008). Patients undergoing direct surgical hospital admission had a significantly lower time to decompression, compared with patients undergoing pre-surgical hospital admission (12 h vs. 26 h, p < 0.0001). Medical stabilization and radiological investigation appeared not to influence the timing of surgery. The time taken to organize the operating theater following surgical hospital admission was a further factor delaying decompression (12.5 h). There was a relationship between the timing of decompression and the proportion of patients demonstrating substantial recovery (2-3 American Spinal Injury Association Impairment Scale grades). In conclusion, the time of cervical spine decompression markedly improved over the study period. Neurological recovery appeared to be promoted by rapid decompression. Direct surgical hospital admission, rapid organization of theater, and where possible, use of closed reduction, are likely to be effective strategies to reduce the time to decompression.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	MARY ANN LIEBERT, INC
dc.relation.ispartof	J Neurotrauma
dc.relation.isbasedon	10.1089/neu.2015.4207
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1103 Clinical Sciences, 1109 Neurosciences
dc.subject.classification	Neurology & Neurosurgery
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Aged
dc.subject.mesh	Australia
dc.subject.mesh	Cervical Cord
dc.subject.mesh	Decompression, Surgical
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	New Zealand
dc.subject.mesh	Outcome and Process Assessment, Health Care
dc.subject.mesh	Spinal Cord Injuries
dc.subject.mesh	Young Adult
dc.subject.mesh	Humans
dc.subject.mesh	Spinal Cord Injuries
dc.subject.mesh	Decompression, Surgical
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Aged
dc.subject.mesh	Middle Aged
dc.subject.mesh	Australia
dc.subject.mesh	New Zealand
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Young Adult
dc.subject.mesh	Cervical Cord
dc.subject.mesh	Outcome and Process Assessment, Health Care
dc.title	Early Decompression following Cervical Spinal Cord Injury: Examining the Process of Care from Accident Scene to Surgery.
dc.type	Journal Article
utslib.citation.volume	33
utslib.location.activity	United States
utslib.for	1103 Clinical Sciences
utslib.for	1109 Neurosciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology/School of Mechanical and Mechatronic Engineering
utslib.copyright.status	closed_access	*
dc.date.updated	2023-02-15T21:19:53Z
pubs.issue	12
pubs.publication-status	Published
pubs.volume	33
utslib.citation.issue	12

Abstract:

Early decompression may improve neurological outcome after spinal cord injury (SCI), but is often difficult to achieve because of logistical issues. The aims of this study were to 1) determine the time to decompression in cases of isolated cervical SCI in Australia and New Zealand and 2) determine where substantial delays occur as patients move from the accident scene to surgery. Data were extracted from medical records of patients aged 15-70 years with C3-T1 traumatic SCI between 2010 and 2013. A total of 192 patients were included. The median time from accident scene to decompression was 21 h, with the fastest times associated with closed reduction (6 h). A significant decrease in the time to decompression occurred from 2010 (31 h) to 2013 (19 h, p = 0.008). Patients undergoing direct surgical hospital admission had a significantly lower time to decompression, compared with patients undergoing pre-surgical hospital admission (12 h vs. 26 h, p < 0.0001). Medical stabilization and radiological investigation appeared not to influence the timing of surgery. The time taken to organize the operating theater following surgical hospital admission was a further factor delaying decompression (12.5 h). There was a relationship between the timing of decompression and the proportion of patients demonstrating substantial recovery (2-3 American Spinal Injury Association Impairment Scale grades). In conclusion, the time of cervical spine decompression markedly improved over the study period. Neurological recovery appeared to be promoted by rapid decompression. Direct surgical hospital admission, rapid organization of theater, and where possible, use of closed reduction, are likely to be effective strategies to reduce the time to decompression.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/166172