Abstract
Scivoletto G, Morganti B, Molinari M. Neurologic recovery of spinal cord injury patients
in Italy. Arch Phys Med Rehabil 2004;85:485–9.
Objective
To evaluate neurologic recovery of spinal cord lesion patients and its relationship
to some lesion and patient features.
Design
Retrospective review of the charts.
Setting
Rehabilitation hospital in Italy.
Participants
A total of 284 consecutive, newly injured patients were included with evaluation of
lesion to admission time, etiology, lesion level, associated injury, medical complications
and surgical intervention, length of stay, and American Spinal Injury Association
(ASIA) impairment grade and motor scores.
Interventions
Not applicable.
Main outcome measures
ASIA impairment grade and motor scores.
Results
Neurologic recovery was present in 27% of the patients. Most patients who improved
and reached a functional status (ASIA class D) had an ASIA class C impairment at admission
(71/129), versus ASIA class A (2/84) and ASIA class B (5/19). The lesion-to-admission
interval was significantly longer in patients who did not improve (73±51.2d vs 47.2±38.4d,
P=.006).
Conclusions
ASIA impairment designations have prognostic value. Recovery from complete lesions
was limited. Patients with ASIA class B impairment at admission had a better prognosis
than those with ASIA class A. Patients with ASIA class C at admission had the best
neurologic improvement. Finally, ASIA class D patients had lower ASIA grade improvement.
Neurologic recovery was negatively associated with patients’ age and delayed rehabilitation,
but not by other lesion features.
Keywords
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References
- Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. Results of the Third National Acute Spinal Cord Injury Randomized Controlled Trial. National Acute Spinal Cord Injury Study.JAMA. 1997; 277: 1597-1604
- Measurements and recovery patterns in a multicenter study of acute spinal cord injury.Spine. 2001; 26: S68-S86
- The John Stanley Coulter Lecture. Predicting recovery after spinal cord injury: a rehabilitation imperative.Arch Phys Med Rehabil. 1999; 80: 361-364
- International Standards for Neurological and Functional Classification of Spinal Cord Injury.Spinal Cord. 1997; 35: 266-274
- Definition of complete spinal cord injury.Paraplegia. 1991; 29: 573-581
- Recovery of neurologic function after spinal cord injury in Israel.Spine. 2002; 27: 1733-1735
- Outcomes following traumatic spinal cord injury. Paralyzed Veterans of America, Washington (DC)1999
- Epidemiology, demographics, and pathophysiology of acute spinal cord injury.Spine. 2001; 26: S2-S12
- Nontraumatic spinal cord injury.Arch Phys Med Rehabil. 1999; 80: 619-623
- Spinal cord injury in Italy.Arch Phys Med Rehabil. 2001; 82: 589-596
- A multicenter investigation in lengths of stay, hospitalization charges, and outcomes for a matched tetraplegia sample.Arch Phys Med Rehabil. 1999; 80: 733-740
- Recovery following complete paraplegia.Arch Phys Med Rehabil. 1992; 73: 784-789
- Motor and sensory recovery following complete tetraplegia.Arch Phys Med Rehabil. 1993; 74: 242-247
- Motor and sensory recovery following incomplete paraplegia.Arch Phys Med Rehabil. 1994; 75: 67-72
- Neurologic recovery after traumatic spinal cord injury.Arch Phys Med Rehabil. 1999; 80: 1391-1396
- Age, outcome and rehabilitation costs after paraplegia caused by traumatic injury of the thoracic spinal cord, conus medullaris and cauda equina.J Neurotrauma. 1999; 16: 805-815
- Nontraumatic vs. traumatic spinal cord injury.Am J Phys Med Rehabil. 2001; 80: 693-699
- Age effects on prognosis for functional recovery in acute, traumatic central cord syndrome.Arch Phys Med Rehabil. 1990; 71: 963-968
- Recovery of ambulation in motor-incomplete tetraplegia.Arch Phys Med Rehabil. 1997; 78: 1169-1172
- Incomplete spinal cord injury.Arch Phys Med Rehabil. 1999; 80: 587-599
- Plasticity of motor systems after incomplete spinal cord injury.Nat Rev Neurosci. 2001; 2: 263-273
- Aging impairs amigdala-hippocampus interactions involved in hyppocampal LTP.Neurobiol Aging. 2002; 23: 319-324
- Neuroplasticity in old age.Ann Neurol. 2002; 52: 135-143
- Prognosis and recovery in ischaemic and traumatic spinal cord injury.J Neurol Neurosurg Psychiatry. 1999; 67: 567-571
- The functional independence measure.Adv Clin Rehabil. 1987; 1: 6-18
- The role of steroids in acute spinal cord injury.Spine. 2001; 26: S39-S46
- The role and timing of decompression in acute spinal cord injury.Spine. 2001; 26: S101-S109
Article info
Footnotes
☆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(s) or upon any organization with which the author(s) is/are associated.
Identification
Copyright
© 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
