Surgical management of spinal cord injury and its impact on long-term neurological recovery
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Spinal cord trauma leads to severe motor, sensory, and socioeconomic sequelae following the initial spinal cord injury and the subsequent cascade of ischemia, edema, and secondary inflammation. To evaluate the impact of the time to surgical decompression on long-term functional neurological recovery. A structured systematic review following the PRISMA guidelines of articles (2020–2026) selected from PubMed, SciELO, LILACS, MEDES, Trip Database, and the scientific journal *Ciencia y Método*. Early decompression (<24 hours) achieved an ASIA scale conversion rate of 17.31% compared to 7.44% for late decompression. Optimizing mean arterial pressure and maintaining strict aseptic conditions for equipment reduced ischemia and postoperative infections. Early relief of mechanical compression halts microvascular deterioration and preserves viable neural pathways. However, there are logistical limitations regarding hospital transfers and ongoing debate regarding corticosteroid-induced immunosuppression. Early surgical decompression is the primary predictor of functional neurological recovery, requiring close coordination with hemodynamic stability, infection control, intensive rehabilitation, and continuous postoperative telemonitoring.
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