Extent of spontaneous motor recovery after traumatic cervical sensorimotor complete spinal cord injury.
METHODS
Retrospective, longitudinal analysis of motor recovery data from individuals with cervical (C4-C7) sensorimotor complete spinal cord injury (SCI) according to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI).


OBJECTIVE
To analyze the extent and patterns of spontaneous motor recovery over the first year after traumatic cervical sensorimotor complete SCI.


METHODS
Datasets from the European multicenter study about SCI (EMSCI) and the Sygen randomized clinical trial were examined for conversion of American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade, change in upper extremity motor score (UEMS) or motor level, as well as relationships between these measures.


RESULTS
There were no overall differences between the EMSCI and Sygen datasets in motor recovery patterns. After 1 year, up to 70% of subjects spontaneously recovered at least one motor level, but only 30% recovered two or more motor levels, with lesser values at intermediate time points. AIS grade conversion did not significantly influence motor level changes. At 1 year, the average spontaneous improvement in bilateral UEMS was 10-11 motor points. There was only moderate relationship between a change in UEMS and a change in cervical motor level (r(2)=0.30, P<0.05). Regardless of initial cervical motor level, most individuals recover a similar number of motor points or motor levels.


CONCLUSIONS
Careful tracking of cervical motor recovery outcomes may provide the necessary sensitivity and accuracy to reliably detect a subtle, but meaningful treatment effect after sensorimotor complete cervical SCI. The distribution of the UEMS change may be more important functionally than the total UEMS recovered.
Steeves
J D
JD
ICORD, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada. steeves@icord.org
Kramer
J K
JK
Fawcett
J W
JW
Cragg
J
J
Lammertse
D P
DP
Blight
A R
AR
Marino
R J
RJ
Ditunno
J F
JF
Coleman
W P
WP
Geisler
F H
FH
Guest
J
J
Jones
L
L
Burns
S
S
Schubert
M
M
van Hedel
H J A
HJ
Curt
A
A
D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D011782:Quadriplegia / Q000503:physiopathology* / Q000534:rehabilitation*; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000473:pathology / Q000503:physiopathology*