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Updated: Sep 5, 2025

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A Novel Method to Classify Cervical Incomplete Spinal Cord Injury Based on Potential for Recovery: A Group-Based

Jetan H Badhiwala1, Jefferson R Wilson1, Abhaya V Kulkarni1

  • 1Division of Neurosurgery, Department of Surgery, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Journal of Neurotrauma
|July 12, 2022
PubMed
Summary
This summary is machine-generated.

This study identified four distinct recovery patterns for cervical incomplete spinal cord injury (SCI) patients, revealing that recovery trajectories can be predicted at baseline using factors like age and injury severity.

Keywords:
cervical incomplete spinal cord injuryoutcomesrecovery trajectoryupper limb motor function

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Clinical Neurology

Background:

  • Outcomes for cervical incomplete spinal cord injury (SCI) are highly variable.
  • Identifying distinct patient subgroups with predictable recovery patterns is crucial for effective management.

Purpose of the Study:

  • To differentiate subgroups of cervical incomplete SCI patients based on their longitudinal upper limb motor function recovery profiles.
  • To develop a predictive model for these recovery trajectories.

Main Methods:

  • Utilized a group-based trajectory model on longitudinal upper extremity motor scores from 801 patients up to 1 year post-injury.
  • Employed multivariable multinomial logistic regression and recursive partitioning for analysis and prediction model development.

Main Results:

  • Identified four distinct recovery trajectories: "Poor outcome," "Moderate recovery," "Good recovery," and "Excellent outcome."
  • Older age was linked to poorer outcomes, while American Spinal Injury Association Impairment Scale (AIS) grades C and D, mid-cervical injuries, and early surgical decompression (<24h) were associated with better recovery.
  • A classification model using age, AIS grade, and neurological level predicted trajectory group with an AUC of 0.81.

Conclusions:

  • Cervical incomplete SCI patients exhibit distinct temporal recovery profiles for upper limb motor function.
  • Baseline characteristics, including age, AIS grade, and neurological level, can predict a patient's likely recovery trajectory with reasonable accuracy.