• Charlotte Y Adegeest, Paula V Ter Wengel, and Wilco C Peul.
• University Neurosurgical Center Holland (UNCH), LUMC | HMC | HAGA, Leiden-The Hague, the Netherlands.
• Curr Opin Crit Care. 2023 Dec 1; 29 (6): 659665659-665.

Purpose Of ReviewSurgical timing in traumatic spinal cord injury (t-SCI) remains a point of debate. Current guidelines recommend surgery within 24 h after trauma; however, earlier timeframes are currently intensively being investigated. The aim of this review is to provide an insight on the acute care of patients with t-SCI.Recent FindingsMultiple studies show that there appears to be a beneficial effect on neurological recovery of early surgical decompression within 24 h after trauma. Currently, the impact of ultra-early surgery is less clear as well as lacking evidence for the most optimal surgical technique. Nevertheless, early surgery to decompress the spinal cord by whatever method can impact the occurrence for perioperative complications and potentially expedite rehabilitation. There are clinical and socioeconomic barriers in achieving timely and adequate surgical interventions for t-SCI.SummaryIn this review, we provide an overview of the recent insights of surgical timing in t-SCI and the current barriers in acute t-SCI treatment.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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