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.
One prospective study (Chen et al. 2012, n=295) examined differences in morbidity of AD in patients with acute SCI treated with surgical decompression at different times (urgent, early and delayed). The study found that patients in the urgent and early surgical decompression groups had lower AD incidence post-operatively and at 6 months follow-up.
There is level 4 evidence from one prospective study (Chen et al. 2012) that earlier surgical decompression after acute SCI results in decreased AD incidence as compared to delayed surgical compression.