Optimal timing of surgical decompression for acute cervical spinal cord injury: a systematic review and network meta-analysis of randomized clinical trials

Background The optimal timing for surgical decompression in acute traumatic cervical spinal cord injury (SCI) remains a subject of intense clinical debate. Objective To evaluate the comparative efficacy and safety of ultra-early (<24 h), early (<72 h), and delayed surgery using a network meta-analysis (NMA) framework. Methods A systematic search of PubMed, Embase, and Web of Science identified randomized controlled trials (RCTs). Primary outcomes included American Spinal Injury Ass