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

@article{Burns2001EstablishingPA,
  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},
  journal={Spine},
  year={2001},
  volume={26},
  pages={S137-S145}
}
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… Expand
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References

SHOWING 1-10 OF 87 REFERENCES
Predicting neurologic recovery in traumatic cervical spinal cord injury.
TLDR
A comprehensive physical examination of the acute SCI patient is essential in determining the initial level and classification of the injury and is the most accurate method to predict neurologic recovery. Expand
Functional skills after spinal cord injury rehabilitation: three-year longitudinal follow-up.
TLDR
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. Expand
Medical rehabilitation length of stay and outcomes for persons with traumatic spinal cord injury--1990-1997.
TLDR
High functional status is associated with shorter LOS, discharge to the community, and time spent out of residence, indicating efficiency in the system. Expand
Spinal cord injury: prognosis for ambulation based on quadriceps recovery
TLDR
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. Expand
Spinal cord injury: prognosis for ambulation based on sensory examination in patients who are initially motor complete.
TLDR
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. Expand
Definition of complete spinal cord injury
TLDR
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. Expand
The pattern of reflex recovery during spinal shock
TLDR
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. Expand
Age effect on prognosis for functional recovery in acute, traumatic central cord syndrome.
TLDR
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. Expand
Recovery of motor function after spinal-cord injury--a randomized, placebo-controlled trial with GM-1 ganglioside.
TLDR
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. Expand
Donal Munro Lecture: Functional and neurologic recovery following acute SCI.
TLDR
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. Expand
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