Hyperbaric oxygen therapy for cervical spinal cord injury

Hyperbaric oxygen therapy (HBOT) has been proposed as an adjunctive treatment for spinal cord injury (SCI). This case report is about a male in his early 50s who sustained an acute cervical SCI after a bicycle accident and presented with quadriparesis, sensory deficits, and American Spinal Injury Association Impairment Scale (AIS) grade B injury before surgery. Cervical magnetic resonance imaging (MRI) demonstrated C3-4 and C4-5 disc extrusions with associated intramedullary T2 hyperintensity consistent with cord edema. The patient underwent C3-6 anterior cervical discectomy and fusion one day after injury. HBOT was initiated approximately one week after surgery at 2.0 atmospheres absolute for 60-minute sessions, with treatment frequency varying over time. He completed 348 HBOT sessions across two treatment periods and also underwent rehabilitation and neuromuscular electrical stimulation. During follow-up, the patient demonstrated progressive recovery of ambulation and his AIS grade improved to grade D. Follow-up cervical MRI obtained during the course of HBOT demonstrated interval reduction in intramedullary T2 signal abnormality. Although the effect of HBOT on a spinal cord injury cannot be determined by a single case report, the observed clinical and radiological improvements support further investigation of its potential role as an adjunctive therapy within a multimodal treatment approach for acute cervical SCI.