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World J Orthop. Dec 18, 2020; 11(12): 573-583
Published online Dec 18, 2020. doi: 10.5312/wjo.v11.i12.573
Management of acute spinal cord injury: A summary of the evidence pertaining to the acute management, operative and non-operative management
Darren Sandean
Darren Sandean, Department of Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, United Kingdom
Author contributions: Sandean D was involved in the conception of the mini-review and write up of the entire manuscript.
Conflict-of-interest statement: The author has no conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Darren Sandean, MBBS, Spine Fellow, Surgeon, Department of Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester LE1 5WW, United Kingdom. darren.sandean@nhs.net
Received: July 19, 2020
Peer-review started: July 19, 2020
First decision: October 21, 2020
Revised: October 28, 2020
Accepted: November 12, 2020
Article in press: November 12, 2020
Published online: December 18, 2020
Processing time: 147 Days and 18.3 Hours
Abstract

Acute traumatic spinal cord injury is often a lifechanging and devastating event with considerable mortality and morbidity. Over half a million people suffer from traumatic spinal cord injury annually with the majority resulting from road traffic accidents or falls. The Individual, societal and economic costs are enormous. Initial recognition and treatment of acute traumatic spinal cord injury are crucial to limit secondary injury to the spinal cord and to provide patients with the best chance of some functional recovery. This article is an overview of the management of the acute traumatic spinal cord injury patient presenting to the emergency department. We review the initial assessment, criteria for imaging and clearing the spine, and evaluate the literature to determine the optimum timing of surgery and the role of non-surgical treatment in patients presenting with acute spinal cord injury.

Keywords: Traumatic spinal cord injury; Acute management; Spinal fracture; Vertebral fracture; Spinal cord transection; Traumatic myelopathy

Core Tip: This article is aimed to guide the clinician treating the patient with suspected traumatic spinal cord injury in the emergency department. It highlights the acute management, timing and factors pertaining to surgery and considerations for non-surgical management.