Comparison of health outcomes between traumatic spinal cord and cauda equina injuries

Retrospective cohort study of prospectively registered and collected data.

To compare the outcomes of people with a traumatic spinal cord injury (SCI) or cauda equina injury (CEI).

Victorian State Trauma System, Australia.

People from the Victorian State Trauma Registry (VSTR) with a diagnosis of traumatic SCI below T4 or CEI, with a date of injury from 2010 to December 2022, were included. Participants were divided into two groups; upper motor neuron (UMN) and lower motor neuron (LMN) injury groups. Demographic, injury event, and hospital details were extracted. Follow-up was conducted by the registry up to 24-months post injury, including the World Health Organization Disability Assessment Schedule (WHODAS), EuroQol EQ-5D scale, and return to work.

Of the 1156 participants, 1113 were categorised as UMN, and 43 as LMN. Within both groups, the demographics were similar. Mixed effect regression modelling of the EQ-5D outcomes over time showed little improvement for both groups. The return to work rate was higher for the LMN injury group at all follow-up time points, with 57% of the UMN injury group returning to work at 24 months post-injury compared to 72% of the LMN injury group. At 24 months post-injury, 63% of people in the UMN injury group reported a WHODAS score equal or greater to ten, compared to 65% in the LMN injury group.

The patient demographics within the two groups were similar. Overall quality of life outcomes remained similarly poor over time for both groups, with little improvement.