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Experimental Strategies to Bridge Large Tissue Gaps in the Injured Spinal Cord after Acute and Chronic Lesion
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Nontraumatic Spinal Cord Injury: Surgical Treatment and Long-Term Outcomes
Qi-Shuai Yu1,2, Guang-Yu Qiao2, Xin-Guang Yu1,2
1School of Medicine, Nankai University, Tianjin, China.
Spine
|September 16, 2025
Summary
Surgery and rehabilitation significantly improve outcomes for patients with nontraumatic spinal cord injury (NTSCI). Etiology and prior operations impact neurological recovery, while etiology and symptom onset influence survival rates in NTSCI patients.
Area of Science:
- Neurosurgery
- Spinal Cord Injury Research
- Clinical Outcomes Analysis
Background:
- Nontraumatic spinal cord injury (NTSCI) incidence is rising, surpassing traumatic spinal cord injury in some regions.
- Limited understanding exists regarding the long-term outcomes of surgically treated NTSCI patients.
- Degenerative cervical myelopathy is the leading cause of NTSCI in the studied population.
Purpose of the Study:
- To analyze the demographics and clinical features of surgically treated NTSCI patients.
- To evaluate the long-term outcomes, including neurological improvement and survival rates.
- To identify prognostic factors influencing recovery and survival in NTSCI.
Main Methods:
- Retrospective cohort study including 212 NTSCI patients undergoing surgery (2010-2022).
- Primary outcomes: American Spinal Injury Association Impairment Scale (AIS) grade improvement and overall survival.
- Statistical analysis: Logistic and Cox regression models were employed.
Main Results:
- Post-surgery, 15.6% improved to AIS E, with a significant reduction in AIS A-C patients (34.9% to 29.2%, P <0.001).
- Hospital-based rehabilitation demonstrated significant AIS improvement (P <0.001); long-term follow-up (mean 102.4 months) showed 42% achieved AIS E.
- Five-year and 10-year overall survival rates were 99.1% and 88.7%, respectively. Etiology and prior operation history were independent factors for AIS improvement.
Conclusions:
- Surgical intervention and rehabilitation significantly enhance clinical outcomes for NTSCI patients.
- Etiology and history of operation are key predictors of neurological improvement (AIS grade).
- Etiology and time of symptom worsening independently predict overall survival in NTSCI patients.
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