Recovery of spinal cord function

Sixty-five per cent of cervical dorsal injuries with neurological change will be incomplete on admission whilst 5 to 50% lumbo dorsal neurological injury will manifest root sparing. The presence of such neurological incompleteness improves the prognosis. Results of long-term neurological examination and observation and their application over a period of years are less well known. Over a period of 22 years subsequent to the establishment of the Spinal Paralysis Unit in Perth, Western Australia, a small series of 17 cases originally admitted to hospital with complete paraplegia or tetraplegia (and substantiated by clinical examination on admission and discharge initially) showed interesting clinical change over a 10 to 15 years observation period. These changes are only sensory: (a) Improvement in somatic function, (b) Improvement in autonomic function. Such improvement resulted in patients having sensation at a useful level, although no real attempt had been made to develop this sensation over a period of time. In no case was long-term motor recovery noted of use. Careful regular monitoring of neurological dysfunction is of value. Repeated stimuli of many types should be used in the treatment to improve sensory function. Rehabilitation of sensory function is of much more importance than has been hitherto discussed.