Outcomes in patients admitted for rehabilitation with spinal cord or cauda equina lesions following degenerative spinal stenosis.
OBJECTIVE
To evaluate outcome measures and the factors affecting them in patients treated between 1,962 and 2,000 at Loewenstein Rehabilitation Hospital, Israel.


METHODS
This retrospective cohort study included 262 patients with spinal neurological lesions (spinal cord or cauda equina lesions) following degenerative spinal stenosis. Data were collected retrospectively. Survival was assessed using the Kaplan-Meier method and the relative mortality risk by the Cox model. Neurological recovery was evaluated by the change in Frankel grades, and factors that affect it were assessed by logistic regression. Associations of length of stay in rehabilitation were analyzed with ANOVA.


RESULTS
Median age at lesion onset was 61 years and median survival 17.6 years. Age at spinal neurological lesion onset was found to be the only factor with a significant effect on survival. Of the 148 patients who had Frankel grades A, B, or C on admission, 58% achieved recovery to grades D and E. Frankel grade at admission, age, and spinal neurological level had a significant effect on recovery. The mean length of stay was 99.7 days, and only Frankel grade had a significant effect on length of stay.


CONCLUSIONS
Patients with spinal stenosis and disabling spinal neurological lesions can achieve significant neurological recovery and survive for many years. They require adequate care in a specialist rehabilitation system.
Ronen
Jacob
J
Lowenstein Rehabilitation Hospital, Ranaana, Tel Aviv, Israel.
Goldin
Diana
D
Itzkovich
Malka
M
Bluvshtein
Vadim
V
Gelernter
Ilana
I
Livshitz
Arkady
A
Folman
Yoram
Y
Catz
Amiram
A
D002420:Cauda Equina; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007557:Israel; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000534:rehabilitation*; D011128:Polyradiculopathy / Q000209:etiology / Q000534:rehabilitation*; D013118:Spinal Cord Diseases / Q000401:mortality / Q000534:rehabilitation*; D013130:Spinal Stenosis / Q000150:complications / Q000534:rehabilitation*; D016896:Treatment Outcome