Clinical predictors of recovery after blunt spinal cord trauma: Systematic review

Amro F. Al-Habib, Najmedden Attabib, Jonathon Ball, Sohail Bajammal, Steve Casha, R. John Hurlbert

Research output: Contribution to journalReview article

27 Scopus citations

Abstract

Several clinical, imaging, and therapeutic factors affecting recovery following spinal cord injury (SCI) have been described. A systematic review of the topic is still lacking. Our primary aim was to systematically review clinical factors that may predict neurological and functional recovery following blunt traumatic SCI in adults. Such work would help guide clinical care and direct future research. Both Medline and Embase (to April 2008) were searched using index terms for various forms of SCI, paraplegia, or quadri/tetraplegia, and functional and neurological recovery. The search was limited to published articles that were in English and included human subjects. Article selection included class I and II evidence, blunt traumatic SCI, injury level above L1-2, baseline assessment within 72h of injury, use of American Spinal Injury Association (ASIA) scoring system for clinical assessment, and functional and neurological outcome. A total of 1526 and 1912 citations were located from Medline and Embase, respectively. Two surgeons reviewed the titles, abstracts, and full text articles for each database. Ten articles were identified, only one of which was level 1 evidence. Age and gender were identified as two patient-related predictors. While motor and functional recovery decreased with advancing age for complete SCI, there was no correlation considering incomplete ones. Therefore, treatment should not be restructured based on age in incomplete SCI. Among injury-related predictors, severity of SCI was the most significant. Complete injuries correlated with increased mortality and worse neurological and functional outcomes. Other predictors included SCI level, energy transmitted by the injury, and baseline electrophysiological testing.

Original languageEnglish (US)
Pages (from-to)1431-1443
Number of pages13
JournalJournal of Neurotrauma
Volume28
Issue number8
DOIs
StatePublished - Aug 1 2011
Externally publishedYes

Keywords

  • American Spinal Injury Association (ASIA)
  • Spinal Cord Independence Measure (SCIM)
  • blunt spinal cord injury
  • traumatic spinal cord injury

ASJC Scopus subject areas

  • Clinical Neurology

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