There are currently no treatments that address the swelling inside the spinal cord after a traumatic spinal cord injury (tSCI). Falls, vehicle accidents, sports injuries, and violence are among the potential causes. After the initial trauma, the injured cord swells — but it is enclosed in the dura, a tough membrane that does not stretch. Pressure builds inside this closed space, squeezing the cord and cutting blood flow to the injured tissue, which causes further damage on top of the original injury.

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Surgeons already operate quickly after a tSCI. The standard operation removes bone around the spine to relieve pressure from the outside and stabilize the damaged vertebrae, but it does not relieve the pressure building inside the dura. This is in contrast to traumatic brain injury, where opening the dura is a routine part of surgery. Animal studies suggest that opening the dura would help after spinal cord injury, and small human studies point the same way, but none were randomized, so the evidence remains inconclusive.

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The DATSCI study is designed to answer that question directly. It tests expansile duraplasty: during the decompression surgery a patient would already be having, the surgeon opens the dura at the injured segment and sews in a patch, enlarging the space so the swelling cord has room to expand. Adults with acute spinal cord injury are randomly assigned to receive the duraplasty or the standard surgery alone, with neither the patient nor the examiners measuring recovery knowing which was done. Because the procedure happens during surgery that is already planned, no additional operation is required. Recovery of movement is tracked for a year, with the main comparison at six months. The study is led by Dr. Rajiv Saigal at UCSF and funded by the US Department of Defense.

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ClinicalTrials.gov Identifier: NCT07280351