Evidence map›Paper›PMID 31992857›Full record

Observational studySpinal cord2020

The use of classification and regression tree analysis to identify the optimal surgical timing for improving neurological outcomes following motor-complete thoracolumbar traumatic spinal cord injury.

Julien Goulet, Andréane Richard-Denis, Jean-Marc Mac-Thiong

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Spinal cord, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Is time really spine? Early versus delayed surgical decompression in traumatic spinal cord injury: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Julien GouletDepartment of Surgery, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin O, Montreal, QC, H4J 1C5, Canada.
Andréane Richard-DenisDepartment of Surgery, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin O, Montreal, QC, H4J 1C5, Canada.ORCID http://orcid.org/0000-0003-3638-4416
Jean-Marc Mac-ThiongDepartment of Surgery, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin O, Montreal, QC, H4J 1C5, Canada. jean-marc.mac-thiong@umontreal.ca.ORCID http://orcid.org/0000-0003-4524-3893

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designObservational cohort study.

objectivesTo identify the optimal surgical timing for improving neurological outcomes in patients that sustained a motor-complete traumatic spinal cord injury (TSCI) secondary to a thoracolumbar injury.

settingLevel 1 trauma center specialized in TSCI care.

methodsWe prospectively analyzed clinical data of 35 patients admitted for motor-complete TSCI secondary to a thoracolumbar injury. We quantified neurological recovery with three different outcomes: the improvement of at least one grade on the American Spinal Injury Association Impairment Scale (AIS), of at least one neurological level of injury (NLI), and of at least 10-points on the motor score (MS). Classification and regression tree analysis was used to identify outcome predictors and to provide cutoff values of surgical timing associated with recovery.

resultsThe proportion of the patients improving by at least one AIS grade was higher in the group undergoing early surgery within 25.7 h of the TSCI (46% vs 0%). The proportion of patients that improved by at least one NLI was also higher in the group undergoing early surgery within 21.5 h of the TSCI (71% vs 18%). Lastly, 25% of the AIS grade A patients undergoing early surgery within 25.6 h of the TSCI improved 10 MS points or more as compared with 0% in the other group.

conclusionsEarlier surgery was effective in improving neurological outcome in motor-complete TSCI at the thoracolumbar levels. Performing surgery within 21.5 h from the traumatic event in these patients increases the likelihood of improving the neurological recovery. SPONSORSHIP: This study was supported by the Fonds de Recherche du Québec-Santé (FRQS), Department of the Army-United States Army Medical Research Acquisition Activity, Rick Hansen Spinal Cord Injury Registry and Medtronic research chair in spinal trauma at Université de Montréal.

Indexed as

Outcome and Process Assessment, Health CareRecovery of FunctionAdultCohort StudiesFemaleHumansLumbar VertebraeMaleMiddle AgedNeurosurgical ProceduresRegression AnalysisSpinal Cord InjuriesStatistics as TopicThoracic VertebraeTime Factors

Identifiers

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.