Impact of Associated Conditions Resulting From Spinal Cord Injury on Health Status and Quality of Life in People With Traumatic Central Cord Syndrome
Presented in part to the American Spinal Injury Association, May 31, 2007, Tampa, FL, and the Canadian Spine Society, March 21–23, 2007, Mount Tremblant, QC, Canada.
Abstract
Noonan VK, Kopec JA, Zhang H, Dvorak MF. Impact of associated conditions resulting from spinal cord injury on health status and quality of life in people with traumatic central cord syndrome.
Objective
To determine the effect of associated spinal cord injury (SCI) conditions on the health status and quality of life (QOL) in people with traumatic central cord syndrome.
Design
Cross-sectional design.
Setting
Community-based.
Participants
Subjects (N=70) with traumatic central cord syndrome who were a minimum of 2 years postinjury.
Interventions
Not applicable.
Main Outcome Measures
Presence of associated SCI conditions (neuropathic pain, spasticity, bowel, bladder, and/or sexual dysfunction, decreased motor function); health status (36-Item Short-Form Health Survey [SF-36], symptom satisfaction); and QOL.
Results
The SF-36 physical component score (PCS) was lower in subjects who reported problems with bowel, bladder, and/or sexual function (−6.9; 95% confidence interval [CI], −11.6 to −2.2). The PCS was decreased in subjects with a lower motor score and this relationship was negatively affected by spasticity and being less educated. The SF-36 mental component score was negatively affected by neuropathic pain and a lower motor score. Neuropathic pain and a lower motor score were both associated with subjects being dissatisfied with their symptoms. Subjects who had a higher motor score were more likely to have a higher QOL (odds ratio, 1.7; 95% CI, 1.1 to 2.7).
Conclusions
The associated SCI conditions bowel, bladder, and/or sexual dysfunction, neuropathic pain, decreased motor function, and spasticity negatively affect the health status of persons with traumatic central cord syndrome. Diminished motor recovery was the only associated SCI condition to impact QOL. By developing a conceptual model and adjusting for confounders, an estimate for each associated SCI condition's effect on patient outcomes was obtained. Our results indicate the importance of treating or ameliorating associated SCI conditions in order to maximize physical and mental functioning.
aDivision of Spine, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
bDepartment of Health Care and Epidemiology, University of British Columbia, Vancouver, BC, Canada
cDepartment of Statistics, University of British Columbia, Vancouver, BC, Canada
dArthritis Research Centre of Canada, Vancouver, BC, Canada.
Reprint requests to Vanessa K. Noonan, MSc, PT, #276-828 West 10th Ave, Vancouver, BC V5Z 1L8, Canada
Supported by the British Columbia Neurotrauma Fund and the Rick Hansen Foundation.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
ABSTRACT