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19-04-2023 | Original Article

Adopting and adapting clinical practice guidelines for timing of decompressive surgery in acute spinal cord injury from a developed world context to a developing region

Authors: Seyed Farzad Maroufi, Sina Azadnajafabad, Ahmad Pour-Rashidi, Seyed Behnam Jazayeri, Zahra Ghodsi, Heshmatollah Ghawami, Maryam Kheyri, Farzin Farahbakhsh, Amir Azarhomayoun, Maryam Bahreini, Jalil Arab Kheradmand, Morteza Faghih Jouibari, Mohammad Zareh, Michael G Fehlings, Vafa Rahimi-Movaghar

Published in: Acta Neurochirurgica | Issue 6/2023

Abstract

Purpose

The proper application of high-quality clinical practice guidelines improves trauma patients’ care and outcomes. This study aimed to adopt and adapt guidelines on the timing of decompressive surgery in acute spinal cord injury (SCI) in Iranian clinical settings.

Methods

This study followed a systematic search and review of the literature to enter them into the selection process. The source guidelines’ clinical suggestions were converted into clinical scenarios for clinical questions on the timing of decompressive surgery. After summarizing the scenarios, we prepared an initial list of recommendations based on the status of the Iranian patients and the health system. The ultimate conclusion was reached with the help of a national interdisciplinary expert panel comprising 20 experts throughout the country.

Results

A total of 408 records were identified. After title and abstract screening, 401 records were excluded, and the full texts of the remaining seven records were reviewed. Based on our screening process, only one guideline included recommendations on the topic of interest. All of the recommendations were accepted by the expert panel with slight changes due to resource availability in Iran. The final two recommendations were the consideration of early surgery (≤24 h) as a treatment option in adult patients with traumatic central cord syndrome and in adult patients with acute SCI regardless of the level of injury.

Conclusion

Considering early surgery for adult patients with acute traumatic SCI regardless of the level of injury was the final recommendation for Iran. Although most of the recommendations are adoptable in developing countries, issues with infrastructure and availability of resources are the limitations.

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Title: Adopting and adapting clinical practice guidelines for timing of decompressive surgery in acute spinal cord injury from a developed world context to a developing region
Authors: Seyed Farzad Maroufi
Sina Azadnajafabad
Ahmad Pour-Rashidi
Seyed Behnam Jazayeri
Zahra Ghodsi
Heshmatollah Ghawami
Maryam Kheyri
Farzin Farahbakhsh
Amir Azarhomayoun
Maryam Bahreini
Jalil Arab Kheradmand
Morteza Faghih Jouibari
Mohammad Zareh
Michael G Fehlings
Vafa Rahimi-Movaghar
Publication date: 19-04-2023
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 6/2023
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-023-05591-w

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Springer Medicine

Adopting and adapting clinical practice guidelines for timing of decompressive surgery in acute spinal cord injury from a developed world context to a developing region

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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