Establishing Prognosis and Maximizing Functional Outcomes After Spinal Cord Injury: A Review of Current and Future Directions in Rehabilitation Management

  title={Establishing Prognosis and Maximizing Functional Outcomes After Spinal Cord Injury: A Review of Current and Future Directions in Rehabilitation Management},
  author={Anthony S. Burns and John Ditunno},
Study Design. Review article. Objectives. To review the medical literature and provide a framework for predicting neurorecovery and functional outcomes after spinal cord injury based on injury severity. Summary of Background Data. The ability to accurately predict the magnitude of neurorecovery and expected functional outcomes after spinal cord injury is of great importance. This information is needed to justify medical and rehabilitation interventions to third party payers as well as to begin… 

Prediction of Patient Outcomes after Traumatic Spinal Cord Injury using Acute Clinical and Radiological Variables

A series of investigations have been undertaken, using a combination of two large prospective SCI datasets, to explore the impact of acute clinical and radiological factors on longterm functional outcome, long-term neurological outcome and in-hospital complication occurrence.

Diagnosis and Prognosis of Traumatic Spinal Cord Injury

The prognostic value of the reviewed diagnostic assessments will become more accurate in the near future, which will provide useful information for physicians to counsel tSCI patients and their families during the catastrophic initial phase after the injury.

Early Predictors of Global Functional Outcome after Traumatic Spinal Cord Injury: A Systematic Review.

A rating of early factors associated to global functional outcome according to their importance and their potential to be modified by the medical/rehabilitation team throughout the early phases of hospitalization is proposed.

A clinical prediction model for long-term functional outcome after traumatic spinal cord injury based on acute clinical and imaging factors.

To improve clinicians' ability to predict outcome after spinal cord injury (SCI) and to help classify patients within clinical trials, we have created a novel prediction model relating acute clinical

Advanced neurological recovery translates into greater long-term functional independence after acute spinal cord injury

This study suggests that the evaluation of temporal recovery profiles can provide novel insights in spinal cord injury clinical trials and suggests that functional independence is significantly higher among patients displaying advanced neurological recovery profile.

Patient selection for clinical trials: the reliability of the early spinal cord injury examination.

It is suggested that it is possible to identify within 48 h of injury, a subset of patients with a negligible chance for motor recovery who would be suitable candidates for future clinical trials of invasive treatments.

Physical rehabilitation as an agent for recovery after spinal cord injury.

  • A. BehrmanS. Harkema
  • Medicine, Psychology
    Physical medicine and rehabilitation clinics of North America
  • 2007

Guidelines for the conduct of clinical trials for spinal cord injury as developed by the ICCP panel: spontaneous recovery after spinal cord injury and statistical power needed for therapeutic clinical trials

The spontaneous rate of recovery after SCI and resulting consequences for achieving statistically significant results in clinical trials are examined, based on previous data of the magnitude of spontaneous recovery afterSCI, as measured by changes in ASIA motor scores.



Predicting neurologic recovery in traumatic cervical spinal cord injury.

Functional skills after spinal cord injury rehabilitation: three-year longitudinal follow-up.

The finding that SCI patients, in this large series, maintained or improved functional levels for three years after discharge is consistent with previous studies and is reassuring to rehabilitation providers.

Medical rehabilitation length of stay and outcomes for persons with traumatic spinal cord injury--1990-1997.

Spinal cord injury: prognosis for ambulation based on quadriceps recovery

In conclusion, motor incomplete spinal cord injured patients who recovered to a > 3/5 quadricep strength by 2 months post injury had an excellent prognosis for subsequent ambulation by 6 monthsPost injury.

Spinal cord injury: prognosis for ambulation based on sensory examination in patients who are initially motor complete.

It is documented that patients with motor complete injury, but preserved pin appreciation, in addition to light touch, below the zone of injury have better prognoses with regard to ambulation than patients with only light touch preserved.

Definition of complete spinal cord injury

Prospective serial neurological examinations were performed on 445 consecutive traumatic spinal cord injury (SCI) patients admitted for rehabilitation on an average of 22.8±15.6 days after injury, in order to compare the definitions in terms of consistency and prognostic ability.

The pattern of reflex recovery during spinal shock

Prognosis for ambulation based on reflexes early after SCI should not be linked to current descriptions of spinal shock and the view of spinalshock, based on the absence of reflexes and the recovery of Reflexes in a caudal to rostral sequence, is of limited clinical utility and should be discarded.

Age effect on prognosis for functional recovery in acute, traumatic central cord syndrome.

The prognosis for functional recovery in acute traumatic CCS should consider the patient's age, and the prognosis is less optimistic in older patients, but it is considerably more favorable in younger patients than previously reported.

Recovery of motor function after spinal-cord injury--a randomized, placebo-controlled trial with GM-1 ganglioside.

Evidence is provided that GM-1 enhances the recovery of neurologic function after one year in patients with spinal-cord injuries and that the increased recovery was attributable to initially paralyzed muscles that regained useful motor strength rather than to strengthening of paretic muscles.

Donal Munro Lecture: Functional and neurologic recovery following acute SCI.

The ability to predict motor recovery provides a rational basis to help support the provider's recommendation for the patient's goals and care planning, as well as differentiates care that is essential for improving functional outcomes from Care that is not.