Nontraumatic spinal cord injury: Incidence, epidemiology, and functional outcome

Objectives: To identify and compare the incidence, demographics, neurologic presentation, and functional outcome of individuals with nontraumatic spin al cord injury (SCI) to individuals with traumatic SCI. Design: A 5-year prospective study. Setting: Level I trauma center of a Regional SCI Model System. Patients: Two hundred twenty adult SCI admissions. Main Outcome Measures: Demographics, etiology, level and completeness of in jury, Functional Independent Measure (FIM) scores. Results: Of SCI admissions, 39% were nontraumatic in etiology (spinal steno sis, 54%; tumor, 26%). Compared to subjects with traumatic SCI, those indiv iduals with nontraumatic SCI were significantly (p <.01) older and were mor e likely married, female, and retired. Injury characteristics revealed sign ificantly more paraplegia and incomplete SCI within the nontraumatic SCI gr oup (p <.01). Both nontraumatic and traumatic SCI individuals had significa nt FIM changes from rehabilitation admission to discharge (p <.01). Those w ith tetraplegia-incomplete nontraumatic SCI had significantly higher admiss ion motor FIM scores and shorter rehabilitation length of stay than in the traumatic group (p <.05). Paraplegic-complete and paraplegic-incomplete non traumatic SCI subjects had lower discharge motor FIM scores, FIM change, an d FIM efficiency than those with traumatic SCI. Similar discharge-to-home r ates were noted in both nontraumatic and traumatic SCI groups. Conclusions: These data suggest that individuals with nontraumatic SCI repr esent a significant proportion of SCI rehabilitation admissions and, althou gh differing from those with traumatic SCI in demographic and injury patter ns, can achieve similar functional outcomes. (C) 1999 by the American Congr ess of Rehabilitation Medicine and the American Academy of Physical Medicin e and Rehabilitation.