title: The potential for functional recovery of upper extremity function following cervical spinal cord injury without major bone injury.
abstract: METHODS
  This was a retrospective observational study.
  
  
  OBJECTIVE
  The objectives were to describe the prognosis of upper extremity function following cervical spinal cord injury (CSCI), and to identify prognostic factors for functional recovery.
  
  
  METHODS
  Spinal Injuries Center, Japan.
  
  
  METHODS
  Sixty patients with C3-4 CSCI without major bone injury participated in the study. Patients were treated nonsurgically and evaluated using the American Spinal Injury Association (ASIA) scales for the upper and lower extremities, their residual cervical motor functions, the modified Frankel grade and an upper extremity function scale. We compared the findings for the upper extremity function scale at 6 months with those for the residual cervical motor functions and modified Frankel grade obtained 3 days after injury.
  
  
  RESULTS
  Most patients with CSCI who could flex their hip and knee from a supine position (95%) or who showed some active elbow extension (86%) 3 days after their injury could use a spoon at 6 months. We compared patients who used their fingers at 6 months to those who could not, and observed significant differences in age and ASIA scores for the upper and lower extremities obtained 3 days after injury. A strong correlation was observed between the initial motor scores and the extent of functional recovery at 6 months.
  
  
  CONCLUSIONS
  Hip and knee flexion from the supine position and elbow extension 3 days after injury significantly predicted a positive prognosis for upper extremity function. Younger age and higher ASIA motor scores obtained 3 days after injury were factors associated with neurological recovery.
authors.affiliation: Department of Orthopedic Surgery, Japan Labour Health and Welfare Organization, Spinal Injuries Center, Fukuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hayashi
authors.forename: O
authors.initials: O
authors.lastname: Kawano
authors.forename: H
authors.initials: H
authors.lastname: Sakai
authors.forename: R
authors.initials: R
authors.lastname: Ideta
authors.forename: T
authors.initials: T
authors.lastname: Ueta
authors.forename: T
authors.initials: T
authors.lastname: Maeda
authors.forename: E
authors.initials: E
authors.lastname: Mori
authors.forename: I
authors.initials: I
authors.lastname: Yugue
authors.forename: T
authors.initials: T
authors.lastname: Takao
authors.forename: M
authors.initials: M
authors.lastname: Masuda
authors.forename: Y
authors.initials: Y
authors.lastname: Morishita
authors.forename: K
authors.initials: K
authors.lastname: Shiba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001842:Bone and Bones / Q000502:physiology; D005260:Female; D006615:Hip / Q000503:physiopathology; D006801:Humans; D007564:Japan; D007717:Knee / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*; D034941:Upper Extremity / Q000503:physiopathology*