PREDICTING NEUROLOGIC RECOVERY IN TRAUMATIC CERVICAL SPINAL-CORD INJURY

Objective: Traumatic spinal cord injury (SCI) affects 8,000 to 10,000 individuals per year in the United States. One of the most difficult t asks confronting the clinician is the discussion of neurologic recover y and prognosis with the patient and/or family. Our objective is to pr ovide a guide for practitioners to accurately predict neurologic outco me in acute traumatic cervical SCI(tetraplegia). Data Source: Publishe d reports obtained through MEDLINE search, texts, and studies presente d at national conferences. Study Selection: Peer reviewed studies, in English language, that discussed prognosis after traumatic SCI. Conclu sion: 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. Other diagnostic tests, including somatosensory evoked potentials, ma gnetic resonance imaging, and transcranial magnetic stimulation, may b e helpful in further determining outcome when used in association with the clinical examination. The understanding of neurologic recovery sh ould help pi-edict ultimate functional capability and potential needs. (C) 1998 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.