Hypothesis of the Study:

Based on the presented results, the investigator hypothesises that HBO preserves neurons that
are not irreversibly damaged (i.e. severed) during initial trauma, thus enabling regain of
their function. The investigator predicts that HBO treatment protects and enhances motor
function in initially paralysed regions, including improvement in function of the extremities
as well as recovery of urinary bladder control and bowel function.

Outline of the Proposed Study:

Within a prospective "proof of principle" trial, a total of 100 patients will be included.
Fifty patients will be recruited at the Division of Thoracic and Hyperbaric Surgery, Medical
University of Graz. In parallel, 50 control patients will be included at the Department of
Orthopaedics and Trauma, Paracelsus University Salzburg, Salzburger Landeskliniken (SALK),
Austria. Thereby, all patients that are admitted at the Medical University of Graz can be
treated and the enrolment of 50 patients into the treatment group can be implemented within
the outlined time frame. The active recruitment period is planned for three years. Both HBO
treated and control patients will undergo the same surgical and nonsurgical procedures. HBO
treatment will be started within 24 hours after the injury. A total of 21 consecutive daily
sessions will be applied, followed by routine rehabilitation programmes. By matching control
and HBO-treated patients, an evaluation of the treatment effect of HBO is possible. The
outcome will be evaluated by implementing the American Spinal Injury Association
(ASIA)-scores and magnet resonance (MR) imaging. Additionally, inflammatory and regenerative
blood markers will be analysed (neuroendocrine markers/neuro-transmitters: S100beta, Brain
Derived Neurotrophic Growth Factor [BDNF], Glial Fibrillary Acidic Protein [GFAP], Reactive
Oxygen Species (ROS), norepinephrine; array of pro- and anti-inflammatory cytokines and
chemokines).