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A 22-year-old male arrives in the trauma bay 3 hours following a diving injury. He is conscious but endorsing severe neck pain. Secondary survey reveals no additional injuries besides the findings shown in Figures A and B. He is evaluated by the orthopaedic resident, who determines he is an ASIA C. Which of the following scenarios will result in the best chance of neurologic recovery?
Methylprednisolone bolus 30mg/kg over 15 minutes with maintenance infusion of 5.4 mg/kg per hour infused for 23 hours
Delaying surgical decompression at least 5 days to avoid a "second hit" by operating in the acute inflammatory window
Administration of methylprednisolone and urgent (< 24 hours) decompression
Urgent surgical decompression (< 24 hours)
Observation in a hard collar and early mobilization
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