Acute spinal cord injuries before and after the New Zealand Spinal Cord Impairment Action Plan.

Abstract

BACKGROUND:Early medical and surgical intervention in acute spinal cord injuries can improve long-term functional outcomes. This study aims to observe the effects of the New Zealand (NZ) Spinal Cord Impairment Action Plan on timing to acute decompression and comparing this to the period prior to the policy change. METHOD:Data were collected in the form a retrospective audit from medical records of 12 patients admitted to Middlemore Hospital from 2010 to 2013 prior to the NZ Spinal Cord Impairment Action Plan, and 11 patients from 2014 to 2015 following the policy change. Time of decompression is defined as either closed reduction or open reduction plus decompression. Patients were transferred from an initial regional hospital to Middlemore Hospital or directly to Middlemore Hospital following injury. Important time points were compared before and after the NZ Spinal Cord Impairment Action Plan. RESULTS:Cox regression modelling was used to compare statistical data. Following the regional policy change, patients had a shorter time of transfer between hospitals, pre-surgical work up, and hence shorter time to decompression. The mean time of injury to decompression before the policy change is 57.8 and 24.9 h after. CONCLUSION:Since implementing the NZ Spinal Cord Impairment Action Plan, time to decompression has been significantly reduced compared with the same group prior.