Systematic Review and Meta-Analysis on Optimal Timing of Surgery for Acute Symptomatic Metastatic Spinal Cord Compression

This study investigates the best time to perform surgery for acute metastatic spinal cord compression (MSCC), a condition where cancer spreads to the spine and puts pressure on the spinal cord. The researchers analyzed data from multiple studies, comparing outcomes when surgery was performed within 24 hours, within 48 hours, or later than 48 hours from the start of symptoms. The goal was to determine the optimal timing for surgery that leads to improved neurological outcomes and minimizes complications for patients with MSCC.

• 1
  Urgent decompression (within 48 hours of symptom onset) leads to significantly better neurological outcomes for patients with a life expectancy of over three months.
• 2
  More than 80% of patients who underwent urgent decompression reported some strength improvement.
• 3
  Complication rates associated with urgent decompression are comparable to emergent decompression and lower than those observed in patients undergoing surgery later.