Hyperbaric oxygen therapy for cervical spinal cord injury

Hyperbaric oxygen therapy (HBOT) has been proposed as an adjunctive treatment for spinal cord injury (SCI). This case report is about a male in his early 50s who sustained an acute cervical SCI after a bicycle accident and presented with quadriparesis, sensory deficits, and American Spinal Injury Association Impairment Scale (AIS) grade B injury before surgery. Cervical magnetic resonance imaging (MRI) demonstrated C3–4 and C4–5 disc extrusions with associated intramedullary T2 hyperintensity consistent with cord edema. The patient underwent C3–6 anterior cervical discectomy and fusion one day after injury. HBOT was initiated approximately one week after surgery at 2.0 atmospheres absolute for 60-minute sessions, with treatment frequency varying over time. He completed 348 HBOT sessions across two treatment periods and also underwent rehabilitation and neuromuscular electrical stimulation. During follow-up, the patient demonstrated progressive recovery of ambulation and his AIS grade improved to grade D. Follow-up cervical MRI obtained during the course of HBOT demonstrated interval reduction in intramedullary T2 signal abnormality. Although the effect of HBOT on a spinal cord injury cannot be determined by a single case report, the observed clinical and radiological improvements support further investigation of its potential role as an adjunctive therapy within a multimodal treatment approach for acute cervical SCI.