Neurologic recovery after traumatic spinal cord injury: data from the Model Spinal Cord Injury Systems.
OBJECTIVE
To present data on neurologic recovery gathered by the Model Spinal Cord Injury (SCI) Systems over a 10-year period.


METHODS
Case series.


METHODS
Twenty-one Model SCI Systems.


METHODS
A total of 3,585 individuals with traumatic SCI admitted between January 1, 1988 and December 31, 1997.


METHODS
Neurologic impairment category; Frankel grade; American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade; motor score.


RESULTS
SCI caused by violence is more likely than SCI from nonviolent etiologies to result in a complete injury. Changes in severity of injury were similar using the older Frankel scale and the newer ASIA Impairment Scale. Individuals who were motor-complete with extended zones of sensory preservation but without sacral sparing were less likely to convert to motor-incomplete status than those with sacral sparing (13.3% vs 53.6%; p < .001). Motor score improvements at 1 year were related to severity of injury, with greater increases for better AIS grades except grade D, because of ceiling effects. Individuals with AIS grade B injuries have a mixed prognosis.


CONCLUSIONS
Neurologic recovery after SCI is influenced by etiology and severity of injury. Multicenter studies on prognostic features such as preserved pin sensation in grade B injuries may identify subgroups with similar recovery patterns. Identification of such groups would facilitate clinical trials for neurologic recovery in acute SCI.
Marino
R J
RJ
Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, New York, USA.
Ditunno
J F
JF
Donovan
W H
WH
Maynard
F
F
D016208:Databases, Factual / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009048:Motor Skills; D020127:Recovery of Function; D013119:Spinal Cord Injuries / Q000145:classification / Q000209:etiology / Q000503:physiopathology*