ArticleEuropean journal of medical research2026
Impact of early versus delayed surgery on 30-day outcomes in traumatic cervical spinal cord injury: a single-center propensity score-matched cohort study.
Article in European journal of medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- [Rehabilitation guidelines and specifications for traumatic spinal cord injury (2025 edition)].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Guideline
- Early Surgical Decompression and Pulmonary Embolism Risk in Traumatic Cervical Spinal Cord Injury: A Propensity Score-Matched National Analysis.Global spine journal · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly surgical decompression for traumatic cervical spinal cord injury has been associated with improved neurological outcomes, but because of heterogeneity across studies there is debate about the optimal timing. Multicenter investigations perhaps offer broad generalizability, but they may lack uniform perioperative management. In this single-center retrospective cohort study, we evaluated the association between surgical timing (within or beyond 24 h) and short-term outcomes under a standardized institutional protocol.
methodsThis study was conducted at a tertiary emergency and critical care center in Japan using a cohort of patients from between 2011 and 2024. Among 512 patients with traumatic cervical spinal cord injury, 337 underwent surgical decompression and/or stabilization and they were included in the analysis. Patients were categorized into early (< 24 h) and delayed (≥ 24 h) surgery groups. Propensity score matching was applied (1:1 nearest neighbor, caliper 0.1) using sex, age, BMI, ASA class, ASIA grade, injury level, injury severity score, cervical dislocation, and procedure type. The primary outcome was neurological improvement at 30 days (≥ 1 ASIA grade). Secondary outcomes were overall complications and respiratory complications within 30 days. Logistic regression analyses were used to identify factors associated with the outcomes.
resultsBefore matching, early surgery was associated with younger age, lower injury severity scores, and more severe neurological impairment. After propensity score matching, 100 matched pairs achieved covariate balance (standardized mean differences < 0.1-0.2). Early surgery was associated with greater neurological improvement (36.0% vs. 23.0%, p = 0.044) and fewer overall complications (31.0% vs. 57.0%, p < 0.001). Respiratory complications showed a trend toward reduction (19.0% vs. 29.0%, p = 0.098). In multivariate analyses, early surgery was independently associated with neurological improvement (OR 2.39, 95% CI 1.19-4.81, p = 0.014) and with reduced complications (OR 0.46, 95% CI 0.21-0.99, p = 0.048).
conclusionsEarly surgical intervention within 24 h after traumatic cervical spinal cord injury was independently associated with improved neurological recovery and reduced short-term complications. These findings support prioritization of early decompression in institutions where surgery within 24 h is possible.
trial registrationThis study was approved by the Wakayama Medical University Institutional Review Board (Approval No. 4618).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.