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16 June 2026

264

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Evidence-based guidelines for long-term care in spinal cord-related decompression illness

Camille Dubois^1,2, Claire Hentzen^1,2, Alexis Schnitzler³, Lucile Daubresse⁴, Jean Morin⁴

¹ Sorbonne University, GRC 01-GREEN, Paris, France
² Neuro-Urology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
³ Department of Physical and Rehabilitation Medicine, Le Vésinet Hospital, Le Vésinet, France
⁴ Department of Hyperbaric Medicine, Sainte-Anne Military Teaching Hospital, Toulon, France

Corresponding author: Dr Camille Dubois, Neuro-Urology Department, Pitié-Salpêtrière Hospital, 47-83 boulevard de l’Hôpital, 75013, Paris, France
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Keywords
Central nervous system; Decompression sickness; Hyperbaric medicine; Scuba diving; Spinal cord injury

Abstract
(Dubois C, Hentzen C, Schnitzler A, Daubresse L, Morin J. Evidence-based guidelines for long-term care in spinal cord-related decompression illness. Diving and Hyperbaric Medicine. 2026 30 June;56(2):161−169. doi: 10.28920/dhm56.2.161-169. PMID: 42290576.)
Introduction: The aim of this review was to synthesise current knowledge and propose structured evidence-based recommendations for long-term care of individuals with spinal cord decompression illness (scDCI) drawing on experience from French clinical settings and the international literature.
Methods: We conducted a systematic search of international and French guidelines for decompression illness (DCI) and spinal cord injury (SCI), including systematic reviews and consensus statements. Additional literature searches were performed in PubMed Central® (1996–2025) to identify evidence relevant to long-term care. Key domains were predefined based on SCI guidelines: lower urinary tract and gastrointestinal function, thromboembolic, autonomic dysreflexia, pulmonary function, pain, and spasticity.
Results: Our findings confirmed the absence of specific long-term follow-up protocols for scDCI. Evidence from SCI guidelines was therefore adapted to this population. We propose structured, evidence-based recommendations that include systematic neurological and urological screening even in apparently recovered patients and risk-adapted follow-up during the first two years.
Conclusions: Long-term outcomes after scDCI remain poorly defined, but sequelae are frequent and may be underdiagnosed. Structured follow-up based on adapted SCI guidelines may improve prognosis, harmonise care, and generate robust data for future prospective studies.

Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.