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Spinal Cord ; 58(9): 980-987, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32371940

ABSTRACT

STUDY DESIGN: Multicenter prospective cohort. OBJECTIVE: 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). SETTING: Specialized spinal cord injury centers in Europe. METHOD: 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. RESULTS: 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. CONCLUSION: 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.


Subject(s)
Cauda Equina Syndrome/physiopathology , Motor Neuron Disease/physiopathology , Outcome Assessment, Health Care , Paraplegia/physiopathology , Recovery of Function/physiology , Spinal Cord Compression/physiopathology , Spinal Cord Injuries/physiopathology , Adult , Cauda Equina Syndrome/etiology , Cauda Equina Syndrome/rehabilitation , Europe , Female , Humans , Lumbar Vertebrae/injuries , Male , Middle Aged , Motor Neuron Disease/etiology , Motor Neuron Disease/rehabilitation , Paraplegia/etiology , Paraplegia/rehabilitation , Prospective Studies , Spinal Cord Compression/etiology , Spinal Cord Compression/rehabilitation , Spinal Cord Injuries/complications , Spinal Cord Injuries/rehabilitation , Thoracic Vertebrae/injuries
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