Early Decompression for Individuals With Traumatic Cervical SCI

A cost effectiveness analysis was conducted comparing early surgical decompression of the spinal cord (<24 hours post-injury) to delayed decompression for individuals with traumatic cervical SCI (Furlan et al. 2016b). Patients from both groups had no difference in gender, age, injury severity or level (i.e ASIA). This study was from the perspective of the Ontario Ministry of Health and Long-term Care. A model with a six-month duration was constructed with inputs from hospital data and information from publicly available sources. Results were stratified by motor complete and motor incomplete SCI. For individuals with motor complete SCI, the total cost for individuals with early decompression was about $11,000 less than delayed decompression and had an improvement in utility of 0.0002. For the motor incomplete cohort the cost of early decompression was about $4,920 less with a utility improvement of 0.01. Both groups showed a reduction in cost and improved quality of life with early decompression. One concern is that other factors, such as comorbidities, may have influenced a delay in decompression and would also impact outcomes.