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.