(1729) Cervical Decompression Surgery for Traumatic Cervical Spinal Cord Injury Improves Respiratory Status

Introduction: Early cervical decompression surgery after traumatic cervical spinal cord injury reportedly improve neurological function, particularly limb motor function. However, few studies have detailed the effects of cervical decompression surgery on respiration. In this study, we aimed to examine the effects of cervical decompression surgery on respiration in patients with severe traumatic cervical spinal cord injury.

Methods: This study involved 43 patients with severe traumatic cervical spinal cord injury (American Spinal Injury Association Impairment Scale (AIS) A-C) who were transported to our emergency center and underwent cervical spine surgery between January 2017 and March 2023. These patients were divided into two groups: the cervical decompression (decompression) and the non-decompression (fixation) groups. The durations of mechanical ventilation, hospital stay, and dopamine use, as well as tracheostomy rates of both groups were retrospectively compared. Statistical analysis was performed using the Mann-Whitney test and Student’s t-test, with p < 0.05 considered statistically significant.

Results: Of the 43 participants, 35 were male. The average age was 68 years, and the average hospital stay was 38 days. There were 34 and 9 patients in the decompression and fixation groups, respectively. Approximately half of the cases were AIS A, and 11 (26%) exhibited cervical dislocations. The decompression group showed significantly shorter durations of mechanical ventilation (8 days vs. 42 days, p=0.007), hospital stay (33 days vs. 61 days, p=0.039), and dopamine use (0 days vs. 11 days, p=0.047), as well as a lower tracheostomy rate (14/34 (41%) vs. 8/9 (89%), p=0.011). Additionally, we subdivided the decompression group based on the time period from injury to surgery completion (within 12 h vs. after 12 h; within 24 h vs. after 24 h) and performed similar analyses. However, we observed no significant differences in the above-mentioned parameters between the two groups.

Conclusions: In patients with severe traumatic cervical spinal cord injury, cervical decompression surgery may shorten the duration of mechanical ventilation and decrease the requirement for tracheostomy. From the perspective of improving respiratory status, cervical decompression surgery 24 h after injury may be effective.