Early surgical management of acute spinal cord injury

Acute surgical decompression accompanied by stabilization and fusion is a safe procedure in patients with spinal cord injury. No patient was made worse by surgery. Patients with partial preservation of function and myelographic defects, i.e., surgical candidates, made better recoveries than those with normal myelograms who were, therefore, not operated upon. These results probably signify greater intrinsic cord damage in the nonsurgical group, but confirm the safety of surgery. We doubt the value of decompression for swollen cords except where there are hematomas. The treatment of cord swelling and ischemia will depend on improved pharmacological regimens.