Early management of adult traumatic spinal cord injury in patients with polytrauma: a consensus and clinical recommendations jointly developed by the World Society of Emergency Surgery (WSES) & the European Association of Neurosurgical Societies (EANS),World Journal of Emergency Surgery

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Early management of adult traumatic spinal cord injury in patients with polytrauma: a consensus and clinical recommendations jointly developed by the World Society of Emergency Surgery (WSES) & the European Association of Neurosurgical Societies (EANS)
World Journal of Emergency Surgery ( IF 6.0 ) Pub Date : 2024-01-18 , DOI: 10.1186/s13017-023-00525-4
Edoardo Picetti ₁ , Andreas K Demetriades _{2,

3} , Fausto Catena ₄ , Bizhan Aarabi ₅ , Fikri M Abu-Zidan ₆ , Oscar L Alves ₇ , Luca Ansaloni ₈ , Rocco A Armonda ₉ , Rafael Badenes ₁₀ , Miklosh Bala ₁₁ , Zsolt J Balogh ₁₂ , Andrea Barbanera ₁₃ , Alessandro Bertuccio ₁₄ , Walter L Biffl ₁₄ , Pierre Bouzat ₁₅ , Andras Buki ₁₆ , Ana Maria Castano-Leon ₁₇ , Davide Cerasti ₁₈ , Giuseppe Citerio _{19,

20} , Federico Coccolini ₂₁ , Raul Coimbra ₂₂ , Carlo Coniglio ₂₃ , Francesco Costa ₂₄ , Federico De Iure ₂₅ , Bart Depreitere ₂₆ , Enrico Fainardi ₂₇ , Michael J Fehlings ₂₈ , Nikolay Gabrovsky ₂₉ , Daniel Agustin Godoy ₃₀ , Peter Gruen ₃₁ , Deepak Gupta ₃₂ , Gregory W J Hawryluk ₃₃ , Raimund Helbok _{34,

35} , Iftakher Hossain _{36,

37} , Peter J Hutchinson ₃₇ , Corrado Iaccarino ₃₈ , Kenji Inaba ₃₉ , Marcel Ivanov ₄₀ , Stanislav Kaprovoy ₄₁ , Andrew W Kirkpatrick ₄₂ , Sam Klein _{43,

44} , Angelos Kolias _{37,

45,

46} , Nikolay A Konovalov ₄₁ , Alfonso Lagares ₁₇ , Laura Lippa ₄₇ , Angelica Loza-Gomez ₄₈ , Teemu M Luoto ₄₉ , Andrew I R Maas _{50,

51} , Andrzej Maciejczak ₅₂ , Ronald V Maier ₅₃ , Niklas Marklund _{54,

55} , Matthew J Martin ₅₆ , Ilaria Melloni ₅₇ , Sergio Mendoza-Lattes ₅₈ , Geert Meyfroidt ₅₉ , Marina Munari ₆₀ , Lena M Napolitano ₆₁ , David O Okonkwo ₆₂ , Yasuhiro Otomo ₆₃ , Marios C Papadopoulos ₆₄ , Ondra Petr ₆₅ , Wilco C Peul ₃ , Aichholz K Pudkrong ₆₆ , Zaffer Qasim ₄₈ , Frank Rasulo ₆₇ , Carla Reizinho ₆₈ , Florian Ringel ₆₉ , Sandro Rizoli ₇₀ , Elham Rostami ₇₁ , Andres M Rubiano ₇₂ , Emanuele Russo ₇₃ , Aarti Sarwal ₇₄ , Jan M Schwab ₇₅ , Franco Servadei ₇₆ , Deepak Sharma ₇₇ , Salman Sharif ₇₈ , Ehab Shiban ₇₉ , Lori Shutter ₈₀ , Philip F Stahel ₈₁ , Fabio S Taccone ₈₂ , Nicole A Terpolilli ₈₃ , Claudius Thomé ₆₅ , Peter Toth ₈₄ , Parmenion P Tsitsopoulos ₈₅ , Andrew Udy ₈₆ , Alexander R Vaccaro ₈₇ , Albert J Varon ₈₈ , Monica S Vavilala ₆₆ , Alexander Younsi ₈₉ , Monika Zackova ₉₀ , Tommaso Zoerle ₉₁ , Chiara Robba ₉₂

Affiliation

Department of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy.
Department of Neurosurgery, Royal Infirmary Edinburgh, Edinburgh, UK.
Leiden University Neurosurgical Centre Holland, HMC-HAGA The Hague & LUMC Leiden, Leiden, The Netherlands.
Emergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy.
Department of Neurosurgery, University of Maryland, Baltimore, MD, USA.
The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
Hospital Lusíadas Porto, Centro Hospitalar de Gaia/Espinho, Porto, Portugal.
Department of Surgery, Pavia University Hospital, Pavia, Italy.
Department of Neurosurgery, Georgetown University School of Medicine and MedStar Washington Hospital Center, Washington, DC, USA.
Department of Anesthesiology and Surgical-Trauma Intensive Care, Hospital Clínic Universitari de Valencia, University of Valencia, Valencia, Spain.
Department of General Surgery, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Department of Traumatology, John Hunter Hospital, Hunter Medical Research Institute and University of Newcastle, Newcastle, Australia.
Department of Neurosurgery, SS Antonio e Biagio e Cesare Arrigo Alessandria Hospital, Alessandria, Italy.
Division of Trauma/Acute Care Surgery, Scripps Clinic Medical Group, La Jolla, CA, USA.
Universite Grenoble Alpes, CHU Grenoble Alpes, Grenoble, France.
School of Medical Sciences, Örebro University, Örebro, Sweden.
Neurosurgery Department, University Hospital "12 de Octubre", Madrid, Spain.
Neuroradiology Unit, Parma University Hospital, Parma, Italy.
School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Department of Neuroscience, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy.
General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy.
Division of Trauma and Acute Care Surgery, Riverside University Health System Medical Center, Riverside, CA, USA.
Department of Anesthesia, Intensive Care and Prehospital Emergency, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy.
Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, University of Milan, Milan, Italy.
Department of Spine Surgery, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy.
Department of Neurosurgery, University Hospital KU Leuven, Louvain, Belgium.
Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
Division of Neurosurgery, Department of Surgery, University of Toronto, Krembil Research Institute, Toronto Western Hospital, Toronto, ON, Canada.
Clinic of Neurosurgery, University Hospital Pirogov, Sofia, Bulgaria.
Neurointensive Care Unit, Sanatorio Pasteur, Catamarca, Argentina.
Department of Neurological Surgery, University of Southern California, Los Angeles, CA, USA.
Department of Neurosurgery, Neurosciences Centre and JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
Neurological Institute, Cleveland Clinic, Akron General Hospital, Fairlawn, OH, USA.
Department of Neurology, Johannes Kepler University Linz, Kepler University Hospital, Linz, Austria.
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Neurocenter, Department of Neurosurgery, Turku University Hospital, Turku, Finland.
Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
Neurosurgery Unit, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.
Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, CA, USA.
Neurosurgery Department, Royal Hallamshire Hospital, Sheffield, UK.
Department of Spinal and Peripheral Nerve Surgery Burdenko Neurosurgical Center, Moscow, Russia.
Departments of Surgery and Critical Care Medicine, Foothills Medical Centre, University of Calgary, Calgary, AB, Canada.
Department of Neurosurgery, Jessa Hospital, Hasselt, Belgium.
Faculty of Medicine and Life Science, Hasselt University, Hasselt, Belgium.
ANAPLASI Rehabilitation Centre, Athens, Greece.
1St Neurosurgery Department, Henry Dunant Hospital Center, Athens, Greece.
Department of Neurosurgery, Ospedale Niguarda, Milan, Italy.
Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Department of Neurosurgery, Tampere University Hospital and Tampere University, Tampere, Finland.
Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium.
Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium.
Department of Neurosurgery, St Luke Hospital, University of Rzeszow, Tarnow, Poland.
Department of Surgery, University of Washington, Seattle, WA, USA.
Department of Clinical Sciences Lund, Neurosurgery, Lund University, Lund, Sweden.
Department of Neurosurgery, Skåne University Hospital, Lund, Sweden.
University of Southern California, Los Angeles, CA, USA.
Division of Neurosurgery, Department of Neurosciences (DINOGMI), IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Department of Orthopaedics, Duke University, Durham, NC, USA.
Department and Laboratory of Intensive Care Medicine, University Hospitals Leuven and KU Leuven, Louvain, Belgium.
Neuro-Intensive Care Unit, University Hospital of Padova, Padua, Italy.
Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA.
Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
National Disaster Medical Center, Tokyo, Japan.
Academic Neurosurgery Unit, St. George's, University of London, London, UK.
Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria.
Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
Department of Neuroanesthesia and Neurocritical Care, Spedali Civili University Affiliated Hospital of Brescia, Brescia, Italy.
Departamento de Neurocirurgia, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
Department of Neurosurgery, University Hospital Mainz, Mainz, Germany.
Trauma Surgery Department, Hamad General Hospital, HMC, Doha, Qatar.
Section of Neurosurgery, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Neurosciences Institute, El Bosque University, Bogotá, Colombia.
Anesthesia and Intensive Care Unit, AUSL Romagna, M.Bufalini Hospital, Cesena, Italy.
Department of Neurology, Atrium Wake Forest School of Medicine, Winston Salem, NC, USA.
Belford Center for Spinal Cord Injury and Departments of Neurology and Neuroscience, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
Humanitas Research Hospital-IRCCS & Humanitas University, Rozzano, Milan, Italy.
Neuroanesthesia & Perioperative Neuroscience, University of Washington, Seattle, WA, USA.
Department of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan.
Department of Neurosurgery, University Hospital Augsburg, Augsburg, Germany.
Department of Critical Care Medicine, Neurology and Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
Department of Intensive Care, Hopital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
Department of Neurosurgery, LMU Hospital, Ludwig-Maximilian-University Munich, Munich, Germany.
Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary.
Department of Neurosurgery, Hippokration General Hospital, Aristotle University School of Medicine, Thessaloníki, Greece.
Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, VIC, 3004, Australia.
Department of Orthopedic Surgery, Delaware Valley Spinal Cord Injury Center, Rothman Orthopedics, Sidney Kimmel Medical Center of Thomas Jefferson University, Philadelphia, PA, USA.
Department of Anesthesiology, Perioperative Medicine, and Pain Management, University of Miami Miller School of Medicine/Ryder Trauma Center, Miami, FL, USA.
Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
Division of Intensive Care and Neurology Unit, Montecatone Rehabilitation Institute, Imola, Italy.
Department of Pathophysiology and Transplantation, University of Milan, Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
IRCCS Policlinico San Martino, Dipartimento di Scienze Chirurgiche Diagnostiche e Integrate, Università di Genova, Genoa, Italy.

The early management of polytrauma patients with traumatic spinal cord injury (tSCI) is a major challenge. Sparse data is available to provide optimal care in this scenario and worldwide variability in clinical practice has been documented in recent studies. A multidisciplinary consensus panel of physicians selected for their established clinical and scientific expertise in the acute management of tSCI polytrauma patients with different specializations was established. The World Society of Emergency Surgery (WSES) and the European Association of Neurosurgical Societies (EANS) endorsed the consensus, and a modified Delphi approach was adopted. A total of 17 statements were proposed and discussed. A consensus was reached generating 17 recommendations (16 strong and 1 weak). This consensus provides practical recommendations to support a clinician’s decision making in the management of tSCI polytrauma patients.

中文翻译：

成人多发伤患者创伤性脊髓损伤的早期治疗：世界急诊外科学会 (WSES) 和欧洲神经外科学会协会 (EANS) 联合制定的共识和临床建议

创伤性脊髓损伤 (tSCI) 多发伤患者的早期治疗是一项重大挑战。在这种情况下，可利用稀疏数据提供最佳护理，并且最近的研究记录了全球临床实践的差异。建立了一个多学科共识小组，由不同专业的 tSCI 多发伤患者急性管理方面的临床和科学专业知识选出。世界急诊外科学会 (WSES) 和欧洲神经外科学会协会 (EANS) 认可了该共识，并采用了修改后的德尔菲方法。总共提出并讨论了 17 项声明。达成共识，产生 17 项建议（16 项强，1 项弱）。该共识提供了实用的建议，以支持临床医生在治疗 tSCI 多发伤患者方面的决策。

更新日期：2024-01-18

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