Comparing blunt and penetrating trauma in spinal cord injury: Analysis of long-term functional and neurological outcomes

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Study compared baseline characteristics and neurological and functional outcomes for patients with penetrating spinal cord injury (PSCI) and blunt spinal cord injury (BSCI). Data for 5,316 participants with BSCI and 1,062 with PSCI were extracted from the Spinal Cord Injury Model Systems database from January 1994 to January 2015. Participant injury and demographic characteristics were recorded. Outcomes were measured using the International Standards for Neurological Classification of Spinal Cord Injury and Functional Independence Measure (FIM) motor scores. Outcomes for patients with American Spinal Injury Association Impairment Scale (AIS) complete injuries were analyzed separately from incomplete injuries at three time points: acute hospitalization, SCI rehabilitation, and 1-year follow-up. Patients with PSCI compared to those with BSCI were more likely to present with complete injuries (56.8 vs 35.9 percent) and were less likely to undergo spine surgery (19.6 vs 80.6 percent). For incomplete injuries, no significant differences were observed between groups in FIM scores or AIS grade improvement at 1 year. For complete injuries, patients with BSCI showed an increased one-grade (15.7 vs 9.1 percent) and three-grade (5.4 vs 1.9 percent) AIS improvement at 1 year. Multivariate regression analysis demonstrated an independent effect for BSCI on AIS improvement at 1 year. Patient with PSCI had more complete injuries and lower surgery rates. Patients with complete BSCI showed greater AIS improvement at 1 year, and incomplete injuries show no difference in neurological improvement between groups. Overall, patients with PSCI demonstrated worse functional outcomes at 1 year.

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