Nontraumatic spinal cord injury: incidence, epidemiology, and functional outcome.
OBJECTIVE
To identify and compare the incidence, demographics, neurologic presentation, and functional outcome of individuals with nontraumatic spinal cord injury (SCI) to individuals with traumatic SCI.


METHODS
A 5-year prospective study.


METHODS
Level I trauma center of a Regional SCI Model System.


METHODS
Two hundred twenty adult SCI admissions.


METHODS
Demographics, etiology, level and completeness of injury, Functional Independent Measure (FIM) scores.


RESULTS
Of SCI admissions, 39% were nontraumatic in etiology (spinal stenosis, 54%; tumor, 26%). Compared to subjects with traumatic SCI, those individuals with nontraumatic SCI were significantly (p < .01) older and were more likely married, female, and retired. Injury characteristics revealed significantly more paraplegia and incomplete SCI within the nontraumatic SCI group (p < .01). Both nontraumatic and traumatic SCI individuals had significant FIM changes from rehabilitation admission to discharge (p < .01). Those with tetraplegia-incomplete nontraumatic SCI had significantly higher admission motor FIM scores and shorter rehabilitation length of stay than in the traumatic group (p < .05). Paraplegic-complete and paraplegic-incomplete nontraumatic SCI subjects had lower discharge motor FIM scores, FIM change, and FIM efficiency than those with traumatic SCI. Similar discharge-to-home rates were noted in both nontraumatic and traumatic SCI groups.


CONCLUSIONS
These data suggest that individuals with nontraumatic SCI represent a significant proportion of SCI rehabilitation admissions and, although differing from those with traumatic SCI in demographic and injury patterns, can achieve similar functional outcomes.
McKinley
W O
WO
Department of Physical Medicine and Rehabilitation, Medical College of Virginia/Virginia Commonwealth University, Richmond 23298, USA.
Seel
R T
RT
Hardman
J T
JT
D000328:Adult; D000367:Age Factors; D004651:Employment; D005006:Ethnicity; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008393:Marriage; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology; D012189:Retrospective Studies; D012737:Sex Factors; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D013125:Spinal Neoplasms / Q000150:complications; D013130:Spinal Stenosis / Q000150:complications