Injury severity as primary predictor of outcome in acute spinal cord injury: retrospective results from a large multicenter clinical trial

The Spine Journal : Official Journal of the North American Spine Society
W P Coleman, F H Geisler

Abstract

The prognostic value of injury severity and of anatomical region in acute spinal cord injury is strong, making it hard to evaluate other indicators or assess improvement without considering them. This study documents issues and suggests a practical way to stratify. Retrospective analysis of data prospectively collected for the multicenter trial of GM-1. A total of 760 patients were recruited at 28 centers in North America. Injuries were rostral to T10 and left at least one leg with an American Spinal Injury Association (ASIA) motor score less than 15 of 25. Patients were assessed at baseline using the ASIA Impairment Scale (AIS): Grade A, Grade B, and Grades C and D (combined). They were divided by injury region: cervical or thoracic. The endpoint was marked recovery (MR), defined as improvement of at least two grades from AIS at baseline to Modified Benzel Scale at Week 26. Other endpoints were changes in ASIA Motor, in light touch, and in pin prick scores. Data were verified onsite by a central team of monitors, the database was checked and standard statistical techniques were applied. Recruitment was uneven. In 760 patients, 579 injuries were cervical, and 482 were complete. There were few incomplete thoracic injuries. The c...Continue Reading

Citations

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