Motor Recovery, Functional Status, and Health-Related Quality of Life in Patients With Complete Spinal Cord Injuries

In Brief Study Design. A retrospective cohort with cross- sectional follow-up. Objectives. The primary objective was to determine motor recovery in patients with complete traumatic spinal cord injury (SCI). Secondary objectives included: 1) determining which factors predict local recovery, 2) assessing functional status using the Functional Independence Measure (FIM), and 3) assessing generic health-related quality of life using the Short Form-36 (SF-36). Summary of Background Data. Motor recovery following complete SCI has been documented in the literature; however, it has been difficult to interpret: 1) spinal shock is often not addressed; 2) the definition of complete SCI has changed over the last 10 years; and 3) few studies differentiate between local neurologic recovery in the zone of partial preservation and neurologic recovery caudal to the lesion. Methods. All patients admitted to Vancouver Hospital with a complete SCI between 1994 and 2001 were identified and included in the study if they remained complete following the resolution of spinal shock. Minimum 2-year follow-up consisted of an ASIA motor score, an FIM, and the SF-36. Results. Of 133 patients identified, 94 were eligible and 70 completed follow-up. For the tetraplegic patients, the average ASIA motor score was 11.9 ± 10.7 on admission and 20.1 ± 10.8 at follow-up, a change reflecting local recovery only. For the paraplegic patients, the average ASIA motor score was 49.3 ± 2.4 on admission and 50.6 ± 1.7 at follow-up. Conclusions. Motor recovery does not occur below the zone of injury for patients with complete SCI. Varying degrees of local recovery can be expected in tetraplegic individuals. The primary objective of this study was to evaluate motor recovery in patients with complete spinal cord injury. Seventy patients (30 with tetraplegia and 40 with paraplegia) admitted to Vancouver Hospital were followed-up at a minimum of 2 years postinjury. Recovery in complete spinal cord injury below the zone of partial preservation was not apparent.