Motor recovery, functional status, and health-related quality of life in patients with complete spinal cord injuries.
METHODS
A retrospective cohort with cross- sectional follow-up.


OBJECTIVE
The primary objective was to determine motor recovery in patients with complete traumatic spinal cord injury (SCI). Secondary objectives included: 1) determining which factors predict local recovery, 2) assessing functional status using the Functional Independence Measure (FIM), and 3) assessing generic health-related quality of life using the Short Form-36 (SF-36).


BACKGROUND
Motor recovery following complete SCI has been documented in the literature; however, it has been difficult to interpret: 1) spinal shock is often not addressed; 2) the definition of complete SCI has changed over the last 10 years; and 3) few studies differentiate between local neurologic recovery in the zone of partial preservation and neurologic recovery caudal to the lesion.


METHODS
All patients admitted to Vancouver Hospital with a complete SCI between 1994 and 2001 were identified and included in the study if they remained complete following the resolution of spinal shock. Minimum 2-year follow-up consisted of an ASIA motor score, an FIM, and the SF-36.


RESULTS
Of 133 patients identified, 94 were eligible and 70 completed follow-up. For the tetraplegic patients, the average ASIA motor score was 11.9 +/- 10.7 on admission and 20.1 +/- 10.8 at follow-up, a change reflecting local recovery only. For the paraplegic patients, the average ASIA motor score was 49.3 +/- 2.4 on admission and 50.6 +/- 1.7 at follow-up.


CONCLUSIONS
Motor recovery does not occur below the zone of injury for patients with complete SCI. Varying degrees of local recovery can be expected in tetraplegic individuals.
Fisher
Charles G
CG
Division of Spine, Department of Orthopaedics, University of British Columbia, Vancouver Hospital and Health Sciences Centre, Vancouver, British Columbia, Canada. charles.fisher@vch.ca
Noonan
Vanessa K
VK
Smith
Donna E
DE
Wing
Peter C
PC
Dvorak
Marcel F
MF
Kwon
Brian K
BK
Kwon
Brian
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009068:Movement; D009420:Nervous System / Q000503:physiopathology; D011379:Prognosis; D011782:Quadriplegia / Q000209:etiology / Q000503:physiopathology*; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology*