Timing of cervical spine fixation and its impact on postoperative outcomes: a retrospective analysis.

Abstract

Cervical spinal cord injury (CSCI) patients often require fixation surgery. This study aimed to evaluate the association between timing of cervical spine fixation and short-term patient outcomes. We analyzed five years (2016-2020) of data from the American College of Surgeons Trauma Quality Improvement Program (ACS TQIP), identifying patients who underwent cervical spine fixation following traumatic CSCI. Patients who received fixation within 24 h of injury had lower rates of surgical site infection (SSI) and shorter hospital and ICU length of stay (LOS) compared with those whose surgery was delayed beyond 24 h. The overall incidence of SSI was 0.2% (0.14% superficial, 0.10% deep, and 0.04% organ-space). While early fixation was associated with reduced risk of superficial SSI and shorter LOS/ICU stay, no statistically significant associations were observed for deep or organ-space SSI with mortality. Early cervical spine fixation after traumatic CSCI was associated with reduced infection risk and shorter hospitalization. These findings highlight the potential benefits of timely surgical intervention, though further studies are needed to assess long-term neurological and functional outcomes.