A review and update on the guidelines for the acute non-operative management of cervical spinal cord injury.

Acute traumatic spinal cord injury (SCI) is an important cause of impairment globally with estimates of incidence varying from 10.4 to 83 million inhabitants annually. These injuries typically impact younger individuals, reduce quality of life years, and are costly to patients, with lifetime costs estimated to exceed $ 4 million. Given the lifetime impact of SCI, establishing clear practice guidelines for the acute non-operative management of these injuries remains important. In 2013 the Joint Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) released revised guidelines on the topic of Cervical Spinal Cord Injury (SCI). In the present article, we explore the seven general management subsections of the cervical SCI guidelines, review the key literature supporting each recommendation, and review the additional literature since the publication of the 2013 guidelines. Our review found a paucity of significant updates within several of the SCI guideline sections. As a result of our findings we propose a collaborative, multi-institutional prospective study to evaluate many pressing limitations of the current literature. In particular, the development of common data elements that allow consistent, reproducible data collection should be made a priority.