Background: Symptoms of spinal cord decompression sickness (DCS) occur almost
immediately after emerging from the water. It is recommended that recompression
treatment be performed soon to decrease the bubble size and avoid further tissue
injury.
Unfortunately, there may be significant time delay from surfacing to
recompression. The recompression therapy of which the hyperbaric treatment
is effective is unclear. The purpose of this study was first to
evaluate the effect of delayed hyperbaric treatment, initiated more than 30 hours
after surfacing for DCS and second, to evaluate the different
treatment protocols. Methods: Sixty-eight injured divers presenting symptoms of
spinal cord DCS were retrospectively included from the Seoul Medical Center.
Diving information, time interval between symptom onset, and
hyperbaric treatment were studied. The initial severity of spinal
cord DCS was rated with the Boussuges severity score and muscle power examination
and the presence of sequelae was evaluated at two weeks. Initial recompression
treatment at 2.8-4 ATA (atmospheres absolute) with
100% oxygen breathing or deeper recompression was conducted.
Results: There were no significant differences between each group in age, diving
experience, depth of dive, bottom time of dive, and Boussuges’s score. With
respect to treatment results, for the delayed treatment divers, good recovery was
achieved in 47.1% of the divers. When treatment started early,
good recovery was achieved in 58.8% of the divers. Hyperbaric treatment using the
U.S. Navy Table 6a protocol trended toward a better clinical outcome,
statistically significant (p=0.04) compared to the
U.S. Navy Table 6.
Conclusions: The prognosis was as good as the early treatment when the
recompression therapy was delayed in patients with spinal decompression sickness.
Hyperbaric oxygen treatment was better in the U.S. Navy Table 6a than the U.S.
Navy Table 6 in patients with spinal decompression sickness.

KEYWORDS : Decompression sickness, Hyperbaric oxygenation