Response to Burke et al.: Efficacy of Ultra-Early (24-138.5 h) Surgery with Magnetic Resonance Imaging-Confirmed Decompression in American Spinal Injury Association Impairment Scale Grades A, B, and C Cervical Spinal Cord Injury (DOI: 10.1089/neu.2020.7034).

Abstract

Controversy exists in the timing of spinal cord decompression following severe traumatic spinal cord injury (SCI). In addition, the exact definition of decompression versus anatomical alignment and internal fixation is not adequately defined. We recently questioned the significance of the timing of decompression in severe SCI which was submitted and printed in the J of Neurotrauma with the following title: Efficacy of Ultra-Early (< 12 h), Early (12-24 h), and Late (>24-138.5 h) Surgery with Magnetic Resonance Imaging-Confirmed Decompression in American Spinal Injury Association Impairment Scale Grades A, B, and C Cervical Spinal Cord Injury. Aarabi B, Akhtar-Danesh N, Chryssikos T, Shanmuganathan K, Schwartzbauer GT, Simard JM, Olexa J, Sansur CA, Crandall KM, Mushlin H, Kole MJ, Le EJ, Wessell AP, Pratt N, Cannarsa G, Lomangino C, Scarboro M, Aresco C, Oliver J, Caffes N, Carbine S, Mori K. J Neurotrauma. 2020 Feb 1;37(3):448-457. doi: 10.1089/neu.2019.6606. Epub 2019 Aug 1. PMID: 31310155. Following review of this paper Drs. Burke, Fehlings and Dhall challenged our paper presenting important points: LETTER: Efficacy of Ultra-Early (< 12 h), Early (12-24 h), and Late (>24-138.5 h) Surgery with Magnetic Resonance Imaging-Confirmed Decompression in American Spinal Injury Association Impairment Scale Grades A, B, and C Cervical Spinal Cord Injury. Burke JF, Fehlings MG, Dhall SS. J Neurotrauma. 2020 Apr 16. doi: 10.1089/neu.2020.7034. Online ahead of print. PMID: 32299278. The present submission is in response to this LETTER to the Editor: We tried to answer many of the significant questions presented by the authors aimed at mitigating the present challenges.