Recovery after traumatic thoracic- and lumbar spinal cord injury: the neurological level of injury matters.
Adult
Cauda Equina Syndrome
/ etiology
Europe
Female
Humans
Lumbar Vertebrae
/ injuries
Male
Middle Aged
Motor Neuron Disease
/ etiology
Outcome Assessment, Health Care
Paraplegia
/ etiology
Prospective Studies
Recovery of Function
/ physiology
Spinal Cord Compression
/ etiology
Spinal Cord Injuries
/ complications
Thoracic Vertebrae
/ injuries
Journal
Spinal cord
ISSN: 1476-5624
Titre abrégé: Spinal Cord
Pays: England
ID NLM: 9609749
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
17
06
2019
accepted:
30
03
2020
revised:
26
03
2020
pubmed:
7
5
2020
medline:
29
6
2021
entrez:
7
5
2020
Statut:
ppublish
Résumé
Multicenter prospective cohort. To discern neurological- and functional recovery in patients with a traumatic thoracic spinal cord injury (TSCI), conus medullaris syndrome (CMS), and cauda equina syndrome (CES). Specialized spinal cord injury centers in Europe. Lower extremity motor score (LEMS) and spinal cord independent measure (SCIM) scores from patients with traumatic TSCI, CMS, and CES were extracted from the EMSCI database. Scores from admittance and during rehabilitation at 1, 3, 6, and 12 months were compared. Linear mixed models were used to statistically analyse differences in outcome, which were corrected for the ASIA Impairment Scale (AIS) in the acute phase. Data from 1573 individuals were analysed. Except for the LEMS in patients with a CES AIS A, LEMS, and SCIM significantly improved over time for patients with a TSCI, CMS, and CES. Irrespectively of the AIS score, recovery in 12 months after trauma as measured by the LEMS showed a statistically significant difference between patients with a TSCI, CMS, and CES. Analysis of SCIM score showed no difference between patients with TSCI, CMS, or CES. Difference in recovery between patients with a traumatic paraplegia is based on neurological (motor) recovery. Regardless the ceiling effect in CES patients, patients with a mixed upper and lower motor neuron syndrome (CMS) showed a better recovery compared with patients with a upper motor neuron syndrome (TSCI). These findings enable stratifications of patients with paraplegia according to the level and severity of SCI.
Identifiants
pubmed: 32371940
doi: 10.1038/s41393-020-0463-1
pii: 10.1038/s41393-020-0463-1
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
980-987Investigateurs
Yorck-Bernhard Kalke
(YB)
Jesus Benito
(J)
Joan Vidal
(J)
Klaus Röhl
(K)
Carl Fürstenberg
(C)
Djamel Bensmail
(D)
Marion Saur
(M)
Thomas Meiners
(T)
Michael Baumberger
(M)
Angel Gil-Agudo
(A)
Renate Meindl
(R)
Giorgio Scivoletto
(G)
Herbert Resch
(H)
Stephanie Aschauer-Wallner
(S)
Oswald Marcus
(O)
Mariel Purcell
(M)
Andreas Badke
(A)
Xavier Jordan
(X)
Roland Thietje
(R)
Kerstin Anders
(K)
H S Chhabra
(HS)
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