Neurological and functional recovery after thoracic spinal cord injury

The Journal of Spinal Cord Medicine, 2016 · DOI: 10.1179/2045772314Y.0000000280 · Published: January 1, 2016

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

This study examines how people with thoracic spinal cord injuries (SCI) recover their motor, sensory, and functional abilities. Researchers analyzed data from a large database to understand the typical recovery process. The study looked at factors such as the level of injury, the completeness of the injury, and the age of the patient to see how they affect recovery. The goal was to provide information that can help plan clinical trials for new treatments. The findings suggest that people with complete thoracic SCI above T10 show little neurological recovery. Younger people tend to have better functional recovery than older people, and improvements in the severity of the injury are linked to better self-care and mobility.

Study Duration

2000-2011

Participants

661 subjects with T2–12 spinal cord injuries

Evidence Level

Retrospective analysis

Key Findings

1
Little neurological recovery is seen in persons with complete thoracic SCI, especially with levels above T10.
2
Persons who are older at the time of injury have poorer functional recovery than younger persons.
3
Conversion to a better AIS grade is associated with improvement in self-care and mobility at 1 year.

Research Summary

This study updates neurologic and functional outcomes after traumatic paraplegia using SCIMS data of subjects injured between 2000 and 2011. The findings from this report are similar to reports of neurological recovery from the Sygen and EMSCI databases, and from prior analyses of the SCIMS database. Older persons with SCI are less functional than younger persons at 1-year post injury. Modest differences in FIM scores are seen between those with high vs. low thoracic level injuries.

Practical Implications

Clinical Trial Design

The limited neurological recovery for persons with thoracic complete SCI highlights the value of studying this population in clinical trials for neuroprotection and neuroregeneration.

Rehabilitation Strategies

Rehabilitation programs should consider the age of the patient, as older individuals may require more targeted interventions to improve functional outcomes.

Outcome Measures

Measures that focus on trunk control or seated reaching may be better able to detect functional differences in thoracic SCI, and validated measures would be a welcome addition to current assessments.

Study Limitations

1
This study is limited by incomplete follow up
2
Relatively small sample size for subjects with incomplete SCI
3
The lower FIM scores were most pronounced in subjects aged 60 and older compared to younger subjects.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury