Surgical and Neurointensive Management for Acute Spinal Cord Injury: A Narrative Review

Spinal cord injury (SCI) often results from high-energy trauma, leading to lasting neurologic deficits and significant socioeconomic consequences. Neurointensive care, especially in the early stages post-injury, is crucial for improving outcomes. Early neurointensive care focuses on stabilizing the patient's airway, breathing, and circulation while preventing further spinal damage. Imaging and neurologic assessments guide the management plan. Early surgical decompression within 24 hours is generally recommended for patients with spinal instability or cord compression. Optimal care necessitates a multifaceted approach addressing both neurologic and systemic complications, significantly affecting recovery and long-term quality of life.

• 1
  Early decompressive surgery within 24 hours post-injury is widely supported for patients with spinal instability or cord compression, enhancing motor recovery, especially in incomplete SCI.
• 2
  Maintaining a mean arterial pressure (MAP) between 85–90 mmHg during the initial 5–7 days post-injury can significantly improve neurological outcomes.
• 3
  Comprehensive neurointensive care, including prevention of DVT/PE, respiratory infections, and pressure ulcers, is essential for optimizing outcomes and reducing morbidity in SCI patients.