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Nontraumatic spinal cord injury: incidence, epidemiology, and functional outcome
W O McKinley1, R T Seel, J T Hardman
1Department of Physical Medicine and Rehabilitation, Medical College of Virginia/Virginia Commonwealth University, Richmond 23298, USA.
Objectives:
To identify and compare the incidence, demographics, neurologic presentation, and functional outcome of individuals with nontraumatic spinal cord injury (SCI) to individuals with traumatic SCI.
Design:
A 5-year prospective study.
Setting:
Level I trauma center of a Regional SCI Model System.
Patients:
Two hundred twenty adult SCI admissions.
Main Outcome Measures:
Demographics, etiology, level and completeness of injury, Functional Independent Measure (FIM) scores.
Results:
Of SCI admissions, 39% were nontraumatic in etiology (spinal stenosis, 54%; tumor, 26%). Compared to subjects with traumatic SCI, those individuals with nontraumatic SCI were significantly (p < .01) older and were more likely married, female, and retired. Injury characteristics revealed significantly more paraplegia and incomplete SCI within the nontraumatic SCI group (p < .01). Both nontraumatic and traumatic SCI individuals had significant FIM changes from rehabilitation admission to discharge (p < .01). Those with tetraplegia-incomplete nontraumatic SCI had significantly higher admission motor FIM scores and shorter rehabilitation length of stay than in the traumatic group (p < .05). Paraplegic-complete and paraplegic-incomplete nontraumatic SCI subjects had lower discharge motor FIM scores, FIM change, and FIM efficiency than those with traumatic SCI. Similar discharge-to-home rates were noted in both nontraumatic and traumatic SCI groups.
Conclusions:
These data suggest that individuals with nontraumatic SCI represent a significant proportion of SCI rehabilitation admissions and, although differing from those with traumatic SCI in demographic and injury patterns, can achieve similar functional outcomes.