Recovery following complete paraplegia

Abstract

Motor and sensory recovery were quantified by serial examinations prospectively performed on 148 persons with paraplegia. Of the 142 patients who remained complete injuries at follow-up, none with an initial neurologic level of injury (NLI) above T9 regained any lower extremity motor function at follow-up. Thirty-eight percent of patients with an initial NLI at or below T9 had some return of lower extremity motor function, primarily in the hip flexors and knee initial NLI at or below T9 had some return of lower extremity motor function, primarily in the hip flexors and knee extensors. Twenty percent of the patients with an initial NLI at or below T12 regained sufficient hip flexor and knee extensor strength to reciprocally ambulate using conventional orthoses and crutches. Unlike motor function, recovery of light touch and sharp-dull discrimination was independent of the initial NLI. Six (4%) of the 148 patients demonstrated "late" conversion (more than 4 months after injury) from complete to incomplete spinal cord injury (SCI) status. Two of the 6 patients with an initial NLI at T12 and subsequent annual NLI at L1 and L2 reciprocally ambulated, and three of the 6 patients regained voluntary bladder/bowel control.