Characterizing natural recovery after traumatic spinal cord injury
Publications
Model System:
SCI
Reference Type:
Journal article
Accession No.:
J89302
Journal:
Journal of Neurotrauma
Year, Volume, Issue, Page(s):
, 38, 9, 1267-1284
Publication Website:
Abstract:
Article reviews published data on neurological recovery after traumatic spinal cord injury (SCI) from multiple sources, focusing on the American Spinal Injury Association (ASIA) Impairment Scale (AIS) data in which the sacral sparing definition was applied for determination of completeness. Additional variables influencing outcomes, such as zones of preserved function below the neurological level of injury, patient age, injury mechanism, and gender, are also reviewed. Conversion from a complete to incomplete injury is more common in tetraplegia than paraplegia. The majority of AIS conversion and motor recovery occurs within the first 6 to 9 months, with the most rapid rate of motor recovery occurring in the first three months after injury. Motor score changes, as well as recovery of motor levels, are described with the initial strength of muscles as well as the levels of the motor zone of partial preservation influencing the prognosis. Total motor recovery is greater for patients with initial AIS B than AIS A, and greater after initial AIS C than with motor complete injuries. Older age has a negative impact on neurological and functional recovery after SCI; however, the specific age (whether >50 or >65 years) and underlying reasons for this impact are unclear. Penetrating injury is more likely to lead to a classification of a neurological complete injury compared with blunt trauma and reduces the likelihood of AIS conversion at one year. There are insufficient data to support gender having a major effect on neurological recovery after SCI.
