Skip to main content
. 2011 Aug;28(8):1431–1443. doi: 10.1089/neu.2009.1157

Table 2.

Articles Concerned with Patient-related Predictors in Spinal Cord Injury

Reference, country, score, research design, total sample size Method Outcome
van Hedel and Curt, 2006
Switzerland and Canada
Retrospective cohort n = 98
Downs & Black Score = 12		 Population: age 38 +/− 16.8 yr (avg.), male 77 pts. ASIA A = 78 and B = 20 (motor complete). Tetraplegics = 39, paraplegics = 54.
Treatment: N/A (observational)
Outcome measures: ASIA and SCIM		 1. For each segment in tetraplegic pts, there was 9 point difference on ASIA motor and 4 points on SCIM. This was not found in paraplegics.
2. No significant difference between contributing centers on the outcome.
3. For tetraplegics, there was a high correlation between ASIA motor score and the SCIM-mot (r = 0.73, p < 0.001). While patients with thoracic lesions showed poor relationship between ASIA motor score and SCIM-tot and SCIM-mot.
4. Both in paraplegic and tetraplegic pts, the functional outcome decreased significantly with increasing age.
Fisher et al., 2005; Canada; Downs & Black; score = 17; retrospective cohort; n = 70 Population: age 31.6 +/− 11.5 years (avg.), male 58, female 12 pts. C0-C7 = 30, T1-T12 = 39, L1-2 = 1. All ASIA A. In tetraplegic pts, average admission ASIA motor score 11.8 (+/− 10.7). In paraplegics, average admission ASIA motor was 49.3 (+/− 2.4).
Treatment: N/A (observational)
Outcome measures: ASIA, FIM, SF-36		 1. Avg. ASIA score at follow-up was 20.1 (+/− 10.8) for tetraplegic pts and 50.6 (+/− 1.7) for paraplegic pts. None of tetraplegic pts recovered motor function in the lower extremities.
2. The energy by which the energy associated with the mechanism of injury was a strong predictor with local recovery. Low-energy injuries were associated with 5.5-fold improvement in functional recovery than high-energy mechanisms.
3. There was a non-significant trend (p = 0.052) toward lesser rates of recovery in those 24 years or older.
4. Gender was not found to correlate with motor recovery.
5. Functional recovery using FIM revealed a FIM score of 73 (+/− 21.9) for tetraplegics and 116.3 (+/− 7.8) for paraplegics.
6. FIM score before and after 33 mo (median follow-up) was not different in paraplegics or tetraplegics for PCS or MCS.
7. SF-36 physical component score (PCS) in tetraplegics was 26.2 (+/− 5.4) compared with 29.2 (+/− 8.3) in paraplegics. Mental component score (MCS) was 40.9 (+/− 18) in tetraplegics, 40 (+/− 17.3) in paraplegics.
Coleman and Geisler, 2004; United States; Downs & Black; score = 22; retrospective analysis of RCT data; n = 760 Population: age <30 yr = 367, age≥30 yr = 393. Total cervical (C) cases = 579(76.2%), thoracic (T) cases = 181. AIS A = 482 (C = 332,T = 150), AIS B = 131 (C = 113, T = 18), AIS C&D = 147 (C = 134, T = 13). Complete injuries = 63.4%.
Treatment: data included came from Sygen SCI RCT
Outcome measures: MR defined as increase of at least 2 grades from AIS (at baseline) to modified Benzel scale (at wk 26). Others include changes in ASIA motor, light touch, and pin-prick score.		 1. Two factors were dominant in determining MR at wk 8 and 26:
 a. Injury severity (AIS C&D did better than B, which did better than A).
 b. Injury region: cervical did better than thoracic (given less complete pts in the cervical group and cervical complete did better than thoracic complete pts). However, this factor was confounded by the effect of severity of the lesion.
2. GM-1 drug effect was significant at wk 8 but not at wk 26.
3. Other variables were not significant (spinal surgery, surgical timing, MPSS timing, age, or direct admission to tertiary care).
4. Cervical had less AIS A and more AIS B compared to thoracic. Within AIS A, cervical did better. However, B and C&D groups were the same.
5. New variable consisting of injury/severity can predict marked recovery and distinguish C+T regions within AIS A, but not AIS B or C/D; also a significant predictor of MR.
McKinley et al., 2004; United States; Downs & Black; score = 16; observational; n = 123 Population: mean age 37.65 (+/− 15.83) years, male 78.8%, white 76.7%, African American 18.1%, Asian 2.9%, other 2.3%. MVC 52.9%, falls 28.2%, sports 9.1%. Tetraplegia: incomplete 32.9%, complete 22.1%. Paraplegia: incomplete 17.8%, complete 27.2%.
Treatment: N/A (observational)
Outcome measures: ASIA motor index total score, AIS, neurological, motor, and sensory levels, FIM motor score, length of stay, hospital charge, medical complications, re-hospitalizations		 1. Early surgical group included more women (p = 0.05), paraplegics, and MVC-related injuries.
2. Non-surgical group was significantly older (p = 0.05) and included more incomplete injuries.
3. At 1 yr, change in ASIA motor score was more likely in the non-surgical groups compared to the surgical.
4. Late surgical group had more acute care, hospital charges, length of stay, pneumonia, and atelectasis.
5. No difference found in neurological levels, AIS grade, or FIM motor efficiency between groups.

AIS, ASIA Impairment Scale; FIM, Function Independence Measure; MR, marked recovery; pts, patients; RCT, randomized controlled trial; SCIM, Spinal Cord Independence Measure.