title: Neurological and functional recovery after thoracic spinal cord injury.
abstract: OBJECTIVE
  To describe neurological and functional outcomes after traumatic paraplegia.
  
  
  METHODS
  Retrospective analysis of longitudinal database.
  
  
  METHODS
  Spinal Cord Injury Model Systems.
  
  
  METHODS
  Six hundred sixty-one subjects enrolled in the Spinal Cord Injury Model Systems database, injured between 2000 and 2011, with initial neurological level of injury from T2-12. Two hundred sixty-five subjects had second neurological exams and 400 subjects had Functional Independence Measure (FIM) scores ≥6 months after injury.
  
  
  METHODS
  American Spinal Injury Association Impairment Scale (AIS) grade, sensory level (SL), lower extremity motor scores (LEMS), and FIM.
  
  
  RESULTS
  At baseline, 73% of subjects were AIS A, and among them, 15.5% converted to motor incomplete. The mean SL increase for subjects with an AIS A grade was 0.33 ± 0.21; 86% remained within two levels of baseline. Subjects with low thoracic paraplegia (T10-12) demonstrated greater LEMS gain than high paraplegia (T2-9), and also had higher 1-year FIM scores, which had not been noted in earlier reports. Better FIM scores were also correlated with better AIS grades, younger age and increase in AIS grade. Ability to walk at 1 year was associated with low thoracic injury, higher initial LEMS, incomplete injury and increase in AIS grade.
  
  
  CONCLUSIONS
  Little neurological recovery is seen in persons with complete thoracic SCI, especially with levels above T10. Persons who are older at the time of injury have poorer functional recovery than younger persons. Conversion to a better AIS grade is associated with improvement in self-care and mobility at 1 year.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Lee
authors.forename: Benjamin E
authors.initials: BE
authors.lastname: Leiby
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: Marino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010264:Paraplegia / Q000175:diagnosis / Q000534:rehabilitation*; D020127:Recovery of Function; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D013904:Thoracic Vertebrae / Q000293:injuries*
keywords: Outcomes; Paraplegia; Recovery; Rehabilitation; Spinal cord injuries