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Characterization of neurological recovery following traumatic sensorimotor complete thoracic spinal cord injury


Zariffa, J; Kramer, J L K; Fawcett, J W; Lammertse, D P; Blight, A R; Guest, J; Jones, L; Burns, S; Schubert, M; Bolliger, M; Curt, A; Steeves, J D (2011). Characterization of neurological recovery following traumatic sensorimotor complete thoracic spinal cord injury. Spinal Cord, 49(3):463-471.

Abstract

Study design:Retrospective, longitudinal analysis of sensory, motor and functional outcomes from individuals with thoracic (T2-T12) sensorimotor complete spinal cord injury (SCI).Objectives:To characterize neurological changes over the first year after traumatic thoracic sensorimotor complete SCI.Methods:A dataset of 399 thoracic complete SCI subjects from the European Multi-center study about SCI (EMSCI) was examined for neurological level, sensory levels and sensory scores (pin-prick and light touch), lower extremity motor score (LEMS), ASIA Impairment Scale (AIS) grade, and Spinal Cord Independence Measure (SCIM) over the first year after SCI.Results:AIS grade conversions were limited. Sensory scores exhibited minimal mean change, but high variability in both rostral and caudal directions. Pin-prick and light touch sensory levels, as well as neurological level, exhibited minor changes (improvement or deterioration), but most subjects remained within one segment of their initial injury level after 1 year. Recovery of LEMS occurred predominantly in subjects with low thoracic SCI. The sensory zone of partial preservation (ZPP) had no prognostic value for subsequent recovery of sensory levels or LEMS. However, after mid or low thoracic SCI, 3 segments of sensory ZPP correlated with an increased likelihood for AIS grade conversion.Conclusion:The data suggest that a sustained deterioration of three or more thoracic sensory levels or loss of upper extremity motor function are rare events and may be useful for tracking the safety of a therapeutic intervention in early phase acute SCI clinical trials, if a significant proportion of study subjects exhibit such an ascent.Spinal Cord advance online publication, 12 October 2010

Abstract

Study design:Retrospective, longitudinal analysis of sensory, motor and functional outcomes from individuals with thoracic (T2-T12) sensorimotor complete spinal cord injury (SCI).Objectives:To characterize neurological changes over the first year after traumatic thoracic sensorimotor complete SCI.Methods:A dataset of 399 thoracic complete SCI subjects from the European Multi-center study about SCI (EMSCI) was examined for neurological level, sensory levels and sensory scores (pin-prick and light touch), lower extremity motor score (LEMS), ASIA Impairment Scale (AIS) grade, and Spinal Cord Independence Measure (SCIM) over the first year after SCI.Results:AIS grade conversions were limited. Sensory scores exhibited minimal mean change, but high variability in both rostral and caudal directions. Pin-prick and light touch sensory levels, as well as neurological level, exhibited minor changes (improvement or deterioration), but most subjects remained within one segment of their initial injury level after 1 year. Recovery of LEMS occurred predominantly in subjects with low thoracic SCI. The sensory zone of partial preservation (ZPP) had no prognostic value for subsequent recovery of sensory levels or LEMS. However, after mid or low thoracic SCI, 3 segments of sensory ZPP correlated with an increased likelihood for AIS grade conversion.Conclusion:The data suggest that a sustained deterioration of three or more thoracic sensory levels or loss of upper extremity motor function are rare events and may be useful for tracking the safety of a therapeutic intervention in early phase acute SCI clinical trials, if a significant proportion of study subjects exhibit such an ascent.Spinal Cord advance online publication, 12 October 2010

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:04 Jan 2011 07:36
Last Modified:05 Apr 2016 14:25
Publisher:Nature Publishing Group
ISSN:1362-4393
Publisher DOI:https://doi.org/10.1038/sc.2010.140
PubMed ID:20938451

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