Neurologic recovery of spinal cord injury patients in Italy

Objective: To evaluate neurologic recovery of spinal cord lesion patients and its relationship to some lesion and patient features. Design: Retrospective review of the charts. Setting: Rehabilitation hospital in Italy. Participants: A total of 284 consecutive, newly injured patients were included with evaluation of lesion to admission time, etiology, lesion level, associated injury, medical complications and surgical intervention, length of stay, and American Spinal Injury Association (ASIA) impairment grade and motor scores. Interventions: Not applicable. Main Outcome Measures: ASIA impairment grade and motor scores. Results: Neurologic recovery was present in 27% of the patients. Most patients who improved and reached a functional status (ASIA class D) had an ASIA class C impairment at admission (71/129), versus ASIA class A (2/84) and ASIA class B (5/19). The lesion-to-admission interval was significantly longer in patients who did not improve (73+/-51.2d vs 47.2+/-38.4d, P=.006). Conclusions: ASIA impairment designations have prognostic value. Recovery from complete lesions was limited. Patients with ASIA class B impairment at admission had a better prognosis than those with ASIA class A. Patients with ASIA class C at admission had the best neurologic improvement. Finally, ASIA class D patients had lower ASIA grade improvement. Neurologic recovery was negatively associated with patients' age and delayed rehabilitation, but not by other lesion features.