Timing of surgical intervention in spinal trauma: what does the evidence indicate?

In spite of the prevalence and impact of spinal trauma, significant controversy surrounds many of the topics in the field. The role and timing of surgical intervention after spinal trauma remains one of the most contested topics. This focus issue contains 3 studies, which respectively attempt to define the appropriate timing of surgery in the context of acute spinal cord injury, central cord syndrome, and spinal injuries in the poly-trauma patient. Each of these studies is discussed in detail and directions for future work are suggested. Based on the emerging evidence, it is recommended that patients with major spine trauma or spinal cord injury should undergo surgical treatment, when deemed appropriate, within 24 hours of their injury.