Hyperbaric Oxygen Therapy in Traumatic and Non-Traumatic Spinal Cord Injuries: Insights from Nearly Five Decades of Evidence with Single-Center Experience

<b>Background:</b> Hyperbaric oxygen therapy (HBOT) has been proposed as an adjunctive treatment for spinal cord injuries (SCIs) to mitigate a secondary injury and enhance neurological recovery. While the preclinical evidence is consistently supportive, clinical data remain heterogeneous across traumatic (TSCI) and non-traumatic (NTSCI) etiologies. <b>Methods</b>: A hybrid systematic review was conducted in accordance with the PRISMA 2020 guidelines and included an illustrative single-center clinical case. PubMed, OVID Medline, and Google Scholar were searched for studies published between 1978 and 2024. Due to methodological heterogeneity, qualitative synthesis was performed. <b>Results</b>: Fifty studies comprising 1102 patients were included. Neurological improvement was more frequently observed in incomplete injuries and when HBOT was initiated early. <b>Conclusions:</b> HBOT may represent a useful adjunct in selected SCI patients, although standardized protocols and controlled trials are required to better define its role.