Recovery following ischemic myelopathies and traumatic spinal cord lesions

Abstract

Background: As the general population ages, the rising prevalence of vascular lesions of the spinal cord will become significant. The aim of this study was to compare the neurological and functional outcomes of patients with ischemic spinal cord injury (ISCI) and traumatic spinal cord injury (TSCI). Setting: Spinal cord unit of a rehabilitation hospital in Italy. Study design: Retrospective study. Patients and methods:We studied 179 patients with a TSCI and 68 with an ISCI. At admission and discharge, patients were examined by American Spinal Injury Association (ASIA) standards, Barthel Index, Rivermead Mobility Index and Walking Index for Spinal Cord Injury. Bowel and bladder management and discharge destination were recorded at discharge. Analysis of covariance (ANCOVA) and logistic regression models were used to analyze the effects of the etiology of the lesion, AIS level at admission, site of the lesion and the presence of complications on measured outcomes. Results: Patients with an ISCI were older and experienced fewer cervical lesions and complications at admission. By ANCOVA and logistic regression, age, AIS level and lesion level were the chief predictors of neurological and functional outcome, whereas etiology had no effect on outcome. Conclusions: A diagnosis of ischemia and trauma is not a determinant of neurological and functional recovery in spinal cord injury patients. Instead, the outcome of these patients is influenced by age, lesion level and AIS level.

The effectiveness of inpatients rehabilitation for spinal cord patients in Siriraj hospital

“…[4][5][6] In addition, some studies focused only traumatic or non-traumatic causes of SCI. 6,15 Certain studies aimed to compare between traumatic and nontraumatic SCI. 4,5 Our study did not aim as those studies.…”

“…functional rehabilitation used other functional measures including Functional Independent Measure, 1,3,6,7,9,10 Rivermaid Mobility Index, [4][5][6] Walking Index for Spinal Cord Injury. [4][5][6] In addition, some studies focused only traumatic or non-traumatic causes of SCI. 6,15 Certain studies aimed to compare between traumatic and nontraumatic SCI.…”

“…The following impact does not only limit to the patients but also to their families, communities and the health-care systems in the life-long period. Many of previous studies about SCI inpatient rehabilitation demonstrated the functional improvement of SCI patients after admission for rehabilitation [1][2][3][4][5][6][7][8][9][10] and it is mostly necessary for both acute and chronic SCI patients. The outcomes and factors associated with the outcomes of SCI inpatients rehabilitation, therefore, are significant to be determined.…”

“…Those factors included age, [4][5][6]8 level of spinal cord lesion, 6,8,16 the completeness of spinal cord lesion, 3,16 the characteristic of lesion, 3,4 American Spinal Injury Association (ASIA) impairment scale, 6 the duration after onset of spinal cord lesion, 9,10 the causes of SCI, 1,4,7,8 functional status on admission, 3,8,10 and the length of stay (LOS) during rehabilitation. 8,10,16 Otherwise, there were also the previous studies in our country about SCI inpatient rehabilitation 15,17,18 but all those studies focused on the epidemiological data.…”

Analysis of the factor infulencing functional outcomes in patients with spinal cord injury

“…Тако су Scivoletto и аутори у две своје студије испитивали функционални опоравак упоређујући га код исхемијских и инфламаторних мијелопатија са трауматским повредама кичмене мождине. Резултати њихове студије су показали да нема разлике у функционалном опоравку између испитиваних група и да бољи функционални опоравак зависи од неуролошког нивоа лезија [119,120]. Ones и аутори су упоређивали функционални опоравак код трауматских и нетрауматских повреда и дошли су до истог закључка.…”