Value of early attention to spinal compression syndromes

In a consecutive series of 125 patients with spinal compression syndromes, neurological regression was evaluated in relation to the time interval from (a) initial symptoms (patient delay), (b) diagnostic recognition (diagnostic delay), and (c) decision on treatment (therapeutic delay) until the time of definitive treatment. Patients with benign lesions showed a statistically significant negative correlation between the duration of (a) + (b) + (c) and the therapeutic result. In cancer patients there was a tendency for rapid progression of the disease to give a poorer result than in patients in whom the course was more insidious. In all, 77 patients improved after a short therapeutic delay (14 h), while in the remaining 48 the status was unchanged or worse after a long delay (34 h); this is a highly significant difference.