Prevention of AD in Acute Care

The primary mechanisms of SCI are irreversible; therefore, prevention of AD in acute care are mainly focused on the attenuation of the effects of secondary injuries which are delayed, prolonged, and reversible.

Discussion

One retrospective study (Chen et al. 2012) assessed people with SCI with surgical decompression at different times (urgent, early and delayed). All groups had higher incidence of AD post-operatively and at 6 months, though the delayed group had the biggest increase. However, as the study was not randomized, we cannot determine why this occurred.

Conclusion

There is level 3 evidence (from one case control) (Chen et al. 2012) that earlier surgical decompression after acute SCI results in decreased AD incidence as compared to delayed surgical compression.