Trends in Rates of ASIA Impairment Scale Conversion in Traumatic Complete Spinal Cord Injury

Marino, Ralph J.; Leff, Michael; Cardenas, Diana D.; Donovan, Jayne; Chen, David; Kirshblum, Steve; Leiby, Benjamin E.

doi:10.1089/neur.2020.0038

Cited by 13 publications

(8 citation statements)

References 35 publications

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“…This study assessed the general and bladder‐related QOL from a large group of North American women and men with SCI. In keeping with previous studies of SCI demographics, men were more likely to have complete SCIs compared to women 18 . As this could influence bladder management and QOL, we adjusted for this variable in our comparisons between the male and female participants.…”

Section: Discussionmentioning

confidence: 93%

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General and bladder‐related quality of life: A focus on women living with spinal cord injury

Dekalo

Myers

Kennelly

et al. 2022

Neurourology and Urodynamics

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Objective: To compare bladder symptoms, and urinary and overall quality of life (QOL) among women and men after Spinal cord injury (SCI), and to describe specific aspects of QOL among women with SCI. Methods:We used data from a prospective, multi-center, and cross-sectional study that was carried out from May 2019 to September 2020. Clinical and demographic details were obtained and participants completed two patient reported outcomes: the neurogenic bladder symptoms score-short form (NBSS-SF, which measures bladder symptoms and QOL) and the SF-12 (which measures overall physical and mental health QOL).Results: Our cohort included 135 women and 210 men with SCI. Among the women, the median age was 50, and 40% had a cervical SCI. For general QOL, women with SCI had physical functioning scores similar to men, but lower mental health scores on the SF-12 (46.85 vs. 49.76, p = 0.01). Women had significantly worse overall NBSS (10.76 vs. 9.08, p < 0.001) and NBSS continence domain scores (4.71 vs. 3.66, p < 0.001) compared to men. There were significant differences between overall QOL measures, and bladder symptoms based on bladder management techniques among the women. NBSS-SF symptom scores were better among women who used overactive bladder medications compared to women who did not (8.43 vs. 11.9, p = 0.02) and NBSS-SF QOL domain scores were significantly better among women who underwent surgery and those that used overactive bladder medications.Conclusions: Women have more bladder symptoms (specifically incontinence) compared to men. Symptom burden and overall QOL vary among women who use different bladder management techniques and treatments.

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Section: Discussionmentioning

confidence: 93%

“…In keeping with previous studies of SCI demographics, men were more likely to have complete SCIs compared to women. 18 As this could influence bladder management and QOL, we adjusted for this variable in our comparisons between the male and female participants. We found that women had significantly worse mental health scores than men.…”

Section: Discussionmentioning

confidence: 99%

General and bladder‐related quality of life: A focus on women living with spinal cord injury

Dekalo

Myers

Kennelly

et al. 2022

Neurourology and Urodynamics

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“…However, as recently reported, 1 comparing to historical benchmarks in this field poses the risk of overestimating the real effect of any new therapy, since the outcomes of the spinal cord injured patients have been slowly but steadily improving for the last 30 years. Also, the surgical technique could be technically demanding, prolonging the surgery, and complicating the management of the antithrombotic prophylaxis in the postoperative period.…”

Section: Commentmentioning

confidence: 99%

Acute Implantation of a Bioresorbable Polymer Scaffold in Patients With Complete Thoracic Spinal Cord Injury: 24-Month Follow-up From the INSPIRE Study

et al. 2022

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BACKGROUND: Based on 6-month data from the InVivo Study of Probable Benefit of the Neuro-Spinal Scaffold for Safety and Neurological Recovery in Patients with Complete Thoracic Spinal Cord Injury (INSPIRE) study (NCT02138110), acute implantation of an investigational bioresorbable polymer device (Neuro-Spinal Scaffold [NSS]) appeared to be safe in patients with complete thoracic spinal cord injury (SCI) and was associated with an ASIA Impairment Scale (AIS) conversion rate that exceeded historical controls. OBJECTIVE: To evaluate outcomes through 24 months postimplantation. METHODS: INSPIRE was a prospective, open-label, multicenter, single-arm study. Eligible patients had traumatic nonpenetrating SCI with a visible contusion on MRI, AIS A classification, neurological level of injury at T2-T12, and requirement for open spine surgery ≤96 hours postinjury. RESULTS: Nineteen patients underwent NSS implantation. Three patients had early death determined by investigators to be unrelated to the NSS or its implantation procedure. Seven of 16 evaluable patients (44%) had improvement of ≥1 AIS grade at 6 months (primary end point) to AIS B (n = 5) or AIS C (n = 2). Three patients with AIS B at 6 months had further neurological improvement to AIS C by 12 (n = 2) and 24 (n = 1) months, respectively; none have deteriorated per latest available follow-up. No unanticipated or serious adverse device effects were reported. CONCLUSION In this small group of patients with complete thoracic SCI, acute NSS implantation within the spinal cord appeared to be safe with no long-term neurological issues identified during the 24-month follow-up. Patients remain stable, with additional AIS conversions observed in some patients at 12 months and beyond. These data further support the safety and probable benefit of NSS implantation in this patient population.

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“…A total of 332 patients who underwent surgery for metastatic spine cancer between March 2014 and January 2020 were retrospectively reviewed. Patients who had epidural spinal cord compression with a Bilsky grade 20 of 2 or 3 and who demonstrated preoperative neurological deficits (American Spinal Injury Association [ASIA] 21 Impairment Scale [AIS] grade D or worse) were included. Patients who were without neurological deficits or were operated on because of axial pain were excluded.…”

Section: Methods Study Design and Patient Characteristicsmentioning

confidence: 99%

Factors affecting the prognosis of recovery of motor power and ambulatory function after surgery for metastatic epidural spinal cord compression

Park

Park³

et al. 2022

Neurosurgical Focus

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OBJECTIVE Metastatic epidural spinal cord compression (MESCC) causes neurological deficits that may hinder ambulation. Understanding the prognostic factors associated with increased neurological recovery and regaining ambulatory functions is important for surgical planning in MESCC patients with neurological deficits. The present study was conducted to elucidate prognostic factors of neurological recovery in MESCC patients. METHODS A total of 192 patients who had surgery for MESCC due to preoperative neurological deficits were reviewed. A motor recovery rate ≥ 50% and ambulatory function restoration were defined as the primary favorable endpoints. Factors associated with a motor recovery rate ≥ 50%, regaining ambulatory function, and patient survival were analyzed. RESULTS About one-half (48.4%) of the patients had a motor recovery rate ≥ 50%, and 24.4% of patients who were not able to walk due to MESCC before the surgery were able to walk after the operation. The factors “involvement of the thoracic spine” (p = 0.015) and “delayed operation” (p = 0.041) were associated with poor neurological recovery. Low preoperative muscle function grade was associated with a low likelihood of regaining ambulatory functions (p = 0.002). Furthermore, performing the operation ≥ 72 hours after the onset of the neurological deficit significantly decreased the likelihood of regaining ambulatory functions (p = 0.020). Postoperative ambulatory function significantly improved patient survival (p = 0.048). CONCLUSIONS Delayed operation and the involvement of the thoracic spine were poor prognostic factors for neurological recovery after MESCC surgery. Furthermore, a more severe preoperative neurological deficit was associated with a lesser likelihood of regaining ambulatory functions postoperatively. Earlier detection of motor weaknesses and expeditious surgical interventions are necessary, not only to improve patient functional status and quality of life but also to enhance survival.

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Trends in Rates of ASIA Impairment Scale Conversion in Traumatic Complete Spinal Cord Injury

Cited by 13 publications

References 35 publications

General and bladder‐related quality of life: A focus on women living with spinal cord injury

General and bladder‐related quality of life: A focus on women living with spinal cord injury

Acute Implantation of a Bioresorbable Polymer Scaffold in Patients With Complete Thoracic Spinal Cord Injury: 24-Month Follow-up From the INSPIRE Study

Factors affecting the prognosis of recovery of motor power and ambulatory function after surgery for metastatic epidural spinal cord compression

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