Management of traumatic spinal cord injury in the Nordic countries: a multidisciplinary survey

Scand J Trauma Resusc Emerg Med, 2025 · DOI: https://doi.org/10.1186/s13049-025-01349-8 · Published: January 1, 2025

Simple Explanation

Traumatic spinal cord injuries (TSCI) can lead to significant disabilities affecting motor, sensory, and autonomic functions, impacting independence and quality of life. This study evaluates current clinical practices for TSCI across centers in the Nordic countries. The survey included questions about pre-hospital care, intensive care unit (ICU) management, spine surgery, and TSCI rehabilitation. Clinically active professionals in these domains from hospitals within the five Nordic countries were included. The study found broad similarities in clinical practices across the Nordic countries, with some differences. Pre-hospital services showed similar practices for airway management and patient transport. Augmented blood pressure regimens were widely used in intensive care units.

Study Duration

Not specified

Participants

109 respondents from 22 Nordic centers

Evidence Level

Cross-sectional, observational survey study

Key Findings

1
Preoperative magnetic resonance imaging (MRI) was available to most spine surgeons on a 24/7 basis and considered mandatory prior to surgery by the majority.
2
Surgery was defined as early if performed within 24 hours of the injury by all surveyed surgeons.
3
Postoperative thromboprophylaxis was administered within 48 hours by all centers, and rehabilitation policies were similar overall.

Research Summary

This study surveyed current practices in the Nordic countries for managing traumatic spinal cord injuries (TSCI), covering pre-hospital, intensive care, surgery, and rehabilitation stages. The survey revealed considerable agreement in most clinical domains, aligning with international guidelines, though some center- and country-level differences exist. Key areas examined included pre-hospital spinal clearance, airway management, blood pressure targets in intensive care, timing of surgery, and rehabilitation approaches.

Practical Implications

Standardized Protocols

Encourages harmonization of TSCI management protocols across Nordic countries, especially in areas with observed variability.

Resource Allocation

Highlights the importance of readily available MRI and early surgical intervention for improved patient outcomes.

Continuous Education

Emphasizes the need for ongoing education on updated guidelines and evidence-based practices in TSCI management.

Study Limitations

1
The study acknowledges potential reporting bias due to the relatively low number of participating centers.
2
The small sample size limits the external validity of the findings.
3
Some topics of potential clinical relevance, such as antibiotic therapy and ventilatory strategies in the ICU, were not covered in this survey.

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