AO Spine/Praxis Clinical Practice Guidelines for the Management of Acute Spinal Cord Injury: An Introduction to a Focus Issue

Suffering an acute spinal cord injury (SCI) is a catastrophic event and remains a great challenge for biomedical science; one that has stimulated and stymied decades of global research effort in search of effective treatment options to minimize or reverse paralysis and improve neurological outcome. Clinical practice guidelines can play an important role in evaluating and summarizing the available evidence, and then contextualizing it around the decision-making framework that clinicians are accustomed to working within on a daily basis This Focus Issue provides a snapshot of the existing evidence on these important SCI issues, and a methodologically rigorous framework for developing guidelines (when possible) to help clinicians in their decision-making.

• 1
  Updated guidelines were established for the timing of surgical decompression after acute SCI, with surgical decompression within 24 hours of injury now “recommended” as a treatment option.
• 2
  Updated guidelines were also established for hemodynamic management, with an expanded target range for mean arterial pressure (MAP) of 75-80 to 90-95 mmHg for between 3 to 7 days post-injury now “suggested” as a treatment option.
• 3
  The GDG concluded that early surgical decompression (within 24 hours) be recommended as a treatment option, which reflects a stronger recommendation than what was generated in the 2017 guideline.