Objective The objective of the present study was to evaluate the current practice in terms of timing to surgery in acute
spinal cord injury (ASCI) patients among spinal surgeons from Iberolatinoamerican countries. Methods A descriptive cross-sectional study design as a questionnaire was sent by an email for all members of the Sociedad Ibero Latinoamericana de Columna (SILACO, in the Spanish acronym) and associated societies. Results A total of 162 surgeons answered questions related to the timing for surgery. Sixty-eight (42.0%) considered that ASCI with complete neurology injury should be treated within 12 hours, 54 (33.3%) performed early
decompression within 24 hours, and 40 (24,7%) until the first 48 hours. Regarding ASCI with incomplete neurological injury, 115 (71.0%) would operate in the first 12 hours. There was a significant difference in the proportion of surgeons that would operate ASCI within ≤ 24 hours, regarding the type of injury (complete injury:122 versus incomplete injury:155; p < 0.01). In the case of patients with
central cord syndrome without radiological evidence of instability, 152 surgeons (93.8%) would perform
surgical decompression: 1 (0.6%) in the first 12 hours, 63 (38.9%) in 24 hours, 4 (2.5%) in 48 hours, 66 (40.7%) in the initial
hospital stay, and 18 (11.1%) after neurologic stabilization. Conclusion All inquired surgeons favour early
decompression, with the majority performing surgery in the first 24 hours.
Decompression is performed earlier in cases of incomplete than in complete
injuries. In cases of
central cord syndrome without radiological evidence of instability, there is a tendency towards early
surgical decompression, but the timing is still extremely variable. Future studies are needed to identify the ideal timing for
decompression of this subset of ASCI patients.