Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Evaluation and Treatment of Patients With Thoracolumbar Spine Trauma: Timing of Surgical Intervention

Neurosurgery. 2019 Jan 1;84(1):E53-E55. doi: 10.1093/neuros/nyy362.


Question: Does early surgical intervention improve outcomes for patients with thoracic and lumbar fractures?

Recommendations: There is insufficient and conflicting evidence regarding the effect of timing of surgical intervention on neurological outcomes in patients with thoracic and lumbar fractures. Strength of Recommendation: Grade Insufficient It is suggested that "early" surgery be considered as an option in patients with thoracic and lumbar fractures to reduce length of stay and complications. The available literature has defined "early" surgery inconsistently, ranging from <8 h to <72 h after injury. Strength of Recommendation: Grade B The full version of the guideline can be reviewed at:

Publication types

  • Guideline
  • Systematic Review

MeSH terms

  • Evidence-Based Medicine
  • Guidelines as Topic
  • Humans
  • Lumbar Vertebrae / injuries*
  • Lumbar Vertebrae / surgery*
  • Neurosurgery / standards*
  • Neurosurgical Procedures / methods*
  • Patient Care Planning*
  • Spinal Fractures / surgery
  • Spinal Injuries / surgery*
  • Thoracic Vertebrae / injuries*
  • Thoracic Vertebrae / surgery*