When it comes to improving a patient's outcomes after Spinal Cord Injury (SCI), data now suggests that spinal decompression should be performed as quickly as possible. This information has prompted researchers to take a closer look at how this process could be streamlined in Victoria.

To date, the shortest average time from injury to decompression surgery in humans is 12-14 hours, despite studies suggesting that the surgery should be performed within the first few hours following injury.

Factors such transportation, stabilisation, investigation and organisation of surgery are known to delay this process. Previously there has been no study focused specifically on this issue.

Dr Peter Batchelor from the University of Melbourne's Department of Medicine and Austin Health led a research team to change this.

Dr Batchelor's research team wanted to determine the average time taken to perform decompression on a SCI patient in Victoria, and identify any significant delays that commonly occur between the accident scene and the surgery.

The long term objective of their work was to streamline the movement of patients to enable decompression to be performed as early as possible.

This project was followed by another by Dr Batchelor, examining more specifically the possibility of using immediate induced hypothermia therapy to suspend damage caused to the spinal cord, thereby allowing for decompression to be effectively performed at a later time.

With the support of the TAC, a large-scale multicentre clinical trial is now planned to test the effects of immediate cooling followed by decompression. The trial will be referred to as Immediate Cooling and Emergency Decompression (ICED).

Status

Dr Batchelor's research team delivered a report on the topic of spinal decompression, successfully mapping the process of care from time of injury to decompressed surgery for cases of cervical SCI within Victoria.

This report finds that the average time between injury and decompression surgery has improved significantly over the past four years, but suggests that this delay could be further reduced by streamlining initial admission to a pre-surgical hospital, as well as time taken to organise an operating theatre after the patient had been stabilised.

Dr Batchelor is now working with Ambulance Victoria on establishing the safety and feasibility of the logistical and paramedical components for trailing Induced Hypothermia Therapy as a possible solution to this ongoing issue.

The research team has produced two journal articles as part of this project, looking at pre-clinical studies of early decompression and at therapeutic hypothermia in animal models of spinal cord injury.

This research project will lay the groundwork for the proposed ICED trial.