Recovery of neurologic function following nontraumatic spinal cord lesions in Israel.
METHODS
Retrospective cohort study.


OBJECTIVE
To assess neurologic recovery and the manner in which it is affected by various factors following nontraumatic spinal cord lesions (NTSCLs).


BACKGROUND
NTSCLs comprise a considerable portion of spinal cord lesions. However, information about neurologic recovery in these lesions is scarce.


METHODS
The study sample included 1,085 patients with NTSCL treated between 1962 and 2000 at the premier referral hospital for rehabilitation in Israel. Demographic and clinical data were collected from hospital charts. The degree of neurologic recovery was determined by comparing each patient's Frankel grades of neurologic deficit at first admission to rehabilitation and at discharge from the same hospitalization. The study population was also compared with previously studied 250 patients with traumatic spinal cord lesions (TSCLs).


RESULTS
Complete or substantial neurologic recovery (upgrade to Frankel Grade D or E) occurred during rehabilitation in 51% of patients who were Grade A, B, or C on admission, and in 57% of those who were Grade C. Neurologic recovery in NTSCL during rehabilitation was significantly affected by initial Frankel grade and by NTSCL etiology. Age had a borderline effect. Gender, lesion level, and the decade of rehabilitation did not affect recovery. Recovery rate was usually higher in NTSCLs than in TSCLs.


CONCLUSIONS
The prognosis for neurologic recovery is affected mainly by SCL severity and etiology, and is usually better in NTSCLs than in TSCLs.
Catz
Amiram
A
Department IV, Spinal Rehabilitation, Loewenstein Rehabilitation Hospital, Raanana, Israel. amcatz@post.tau.ac.il
Goldin
Diana
D
Fishel
Beno
B
Ronen
Jacob
J
Bluvshtein
Vadim
V
Gelernter
Ilana
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007405:Intervertebral Disc Displacement / Q000150:complications; D007511:Ischemia / Q000534:rehabilitation; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications; D009187:Myelitis / Q000150:complications; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013116:Spinal Cord / Q000098:blood supply; D013117:Spinal Cord Compression / Q000453:epidemiology / Q000209:etiology / Q000534:rehabilitation* / Q000628:therapy; D016135:Spinal Dysraphism / Q000150:complications; D013125:Spinal Neoplasms / Q000150:complications; D013130:Spinal Stenosis / Q000150:complications; D013166:Spondylitis / Q000150:complications; D016896:Treatment Outcome