Context: Patients with spinal cord injury (SCI) often require tracheostomy as an immediate life-saving measure. Successful decannulation, or removal of the tracheostomy, improves patient quality of life, function, and physical appearance and is considered an important rehabilitative milestone for SCI patients.

Objective: We sought to synthesize the existing published literature on SCI patients undergoing decannulation.

Methods: Ovid MEDLINE, Embase, Web of Science, CINAHL, and Cochrane Central Register of Controlled Trials were systematically searched through July 2, 2019 using appropriate keywords and MeSH terms pertaining to tracheostomy and SCI. Searches were human-subject only without language restrictions. Published literature discussing the outcomes of SCI patients who underwent decannulation were screened using inclusion/exclusion criteria determined a priori and reviewed.

Results: Twenty-six publications were eligible for review and synthesis out of 1,493 unique articles. Over half of the studies were retrospective case series or reports. The research was nearly all published within the fields of physical medicine and rehabilitation, neurology, and pulmonary/critical care. Three themes emerged from review: (1) interdisciplinary or multidisciplinary tracheostomy team management to optimize decannulation processes, (2) non-invasive intermittent positive-pressure ventilatory support instead of tracheostomy-based ventilator support, and (3) wide variation in the reporting of post-decannulation clinical outcomes.

Conclusion: Published research lacks a consistent taxonomy for reporting post-decannulation outcomes in SCI patients. Non-invasive ventilation research could benefit many SCI patients but has been studied in depth primarily by a single authorship group. Further investigation into the socioeconomic and fiscal impact on tracheostomies on SCI patients is warranted.

背景：脊髓损伤 (SCI) 患者通常需要气管切开术作为立即挽救生命的措施。成功拔管或移除气管造口术可改善患者的生活质量、功能和身体外观，并被认为是 SCI 患者康复的重要里程碑。

目的：我们试图综合现有发表的关于接受拔管的 SCI 患者的文献。

方法：使用与气管切开术和 SCI 相关的适当关键字和 MeSH 术语系统搜索了 Ovid MEDLINE、Embase、Web of Science、CINAHL 和 Cochrane Central Register of Controlled Trials，截至 2019 年 7 月 2 日。搜索仅以人类为主体，没有语言限制。使用先验确定的纳入/排除标准筛选讨论接受拔管的 SCI 患者结果的已发表文献并进行审查。

结果：在 1,493 篇独特文章中，有 26 篇出版物符合审查和综合条件。超过一半的研究是回顾性病例系列或报告。该研究几乎全部发表在物理医学和康复、神经病学和肺/重症监护领域。审查提出了三个主题：（1）跨学科或多学科气管切开术团队管理以优化拔管过程，（2）无创间歇性正压通气支持，而不是基于气管切开术的呼吸机支持，以及（3）报告的广泛差异拔管后的临床结果。

结论：已发表的研究缺乏一致的分类法来报告 SCI 患者拔管后的结果。无创通气研究可以使许多 SCI 患者受益，但主要由单一作者组进行了深入研究。有必要进一步调查对 SCI 患者气管切开术的社会经济和财政影响。