Original articleUpper- and Lower-Extremity Motor Recovery After Traumatic Cervical Spinal Cord Injury: An Update From the National Spinal Cord Injury Database
Section snippets
Methods
We extracted demographic and neurologic data from 1994 to 2009 from the NSCISC database. To be included, subjects had to be at least 16 years of age at the time of injury, have a complete neurologic examination recorded within 1 week of injury, and have at least 1 other complete neurologic examination more than 30 days after injury. We excluded children younger than 16 years because the reliability of motor scores may be reduced in these subjects.8 All centers participating in the NSCISC
Results
The 1436 subjects included in the analyses were recruited from 21 different centers. The number of subjects from a single center ranged from 3 to 196. Mean ± SD age at injury was 41±17 years. Thirty-four percent of the sample was 30 years or younger and 14% were older than 60 years at the time of injury. Men made up 80% of the sample. Whites made up 61% of the sample; blacks, 27%; Hispanics, 9%; and other racial groups, 3% (table 1). The most common causes of injury were vehicular collisions
Discussion
Our understanding of the “natural recovery” of neurologic function after SCI has evolved with analyses of the NSCISC, EM-SCI, Sygen, and other databases that have tracked key outcomes over time. The knowledge gained from such analyses has served to inform the design of interventional clinical trials, as well as the discussion of prognosis with patients and clinicians. In this report, we have updated neurologic outcomes from the NSCISC database by using data from patients injured between 1994
Conclusions
Motor recovery of traumatic tetraplegic SCI in the NSCISC database is similar to other published data in terms of AIS grade conversion and motor score improvement. Separating motor scores in upper- and lower-limb components shows different patterns of motor recovery based on AIS grade. Deficits in UEMS persist at 1 year in most motor incomplete patients. Motor level recovery of 2 or more levels in those with cervical complete SCI occurs in only 23.5% of patients. Motor level recovery in those
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2022, Archives of Physical Medicine and RehabilitationCitation Excerpt :This difference may account for some of the variance in reported improvement in these studies.25 For persons with initial AIS grade A injuries, our findings of change in UEMS of 7.8±6.5, LEMS of 2.3±7.4, and TMS of 10.1±11.6 are similar although slightly lower than previous SCIMS database (between 1994 and 2009) results of UEMS change of 8.8± 8.4 (UEMS)19 and LEMS change of 3.3± 9.9.19 Our data are consistent with SCIMS data (between 1988 and 1997) of TMS of 9.6±12.720 and reports from Sygen data analyses of LEMS and TMS change of 2.2 and 9.6 at 26 weeks18 and TMS change of 12.3±13.7 at 1 year.17
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Supported by the National Institute on Disability and Rehabilitation Research, Office of Special Education and Rehabilitative Services, Department of Education (grant no. H133N060011).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
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