Background: There is significant heterogeneity in
neurological recovery after complete (ASIA A) traumatic spinal cord injury
(tSCI). Neurological recovery is often associated with a conversion to a
higher letter grade of the American Spinal Injury Association’s impairment
scale (ASIA). The mechanism of injury (MOI) may play a significant role in
the primary injury and should be considered for greater precision in care.
Methods: We isolated ASIA A cervical tSCI
patients from three multicenter prospective randomized controlled trials
(NACTN, STASCIS, Sygen). Chi-square test with pairwise comparisons with
Bonferroni corrections was performed to compare the proportion of ASIA A
patients that converted to a higher ASIA grade between different MOI.
Results: We identified 486 complete cervical tSCI
patients. For patients who developed tSCI as a result of a fall, a
significant proportion converted to a higher ASIA grade by 52 weeks (p =
0.009). For patients who developed tSCI as a result of a sports injury, a
significantly smaller proportion did not convert to a higher ASIA grade
compared to those that converted (p = 0.034).
Conclusions: Due to the difference in outcomes,
tSCI patients should be treated differently depending on their mechanism of
injury.