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.
The relevance of MRI for predicting neurological recovery following cervical traumatic spinal cord injury