INJURY PATTERN EFFECT ON MOTOR RECOVERY AFTER TRAUMATIC SPINAL-CORD INJURY

Objective: To determine whether type of fracture or gunshot injury cor related with extent of motor impairment at 1 month and/or with the amo unt of motor recovery between 1 month and 1 year, Design: Prospective neurological examinations were performed longitudinally after the reco mmendations of the American Spinal Injury Association (ASIA), Fracture s were classified by the Alien system (cervical spine) or the Denis sy stem (thoracic and lumbar spine), Gunshot injuries were classified bas ed on trajectory and bullet location, Setting: Subjects were examined at a community medical center, Patients: There were 278 patients with traumatic spinal cord injury who were admitted between 1985 and 1990, Main Outcome Measures: The ASIA motor score was the primary outcome me asure, Results: There were no significant differences in motor recover y based on type of injury (penetrating vs nonpenetrating), type of fra cture, or bullet location, Conclusions: Injuries severely disruptive o f the spinal canal were more likely to result in complete SCI, Flexion -rotation injuries in the thoracic and lumbar spine, bilateral facet d islocations in the cervical spine, and gunshot wounds in which the bul let passed through the canal were more likely to be complete, Incomple te injuries were more common among patients with preexisting cervical spondylosis who had fallen and patients with gunshot wounds in which t he bullet did not penetrate the spinal canal, The primary determinant of motor recovery was completeness of injury at 1 month. (C) 1995 by t he American Congress of Rehabilitation Medicine and the American Acade my of Physical Medicine and Rehabilitation