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Recovery of Neurologic Function Following Nontraumatic Spinal Cord Lesions in Israel

Catz, Amiram MD*†; Goldin, Diana MD‡; Fishel, Beno MD‡; Ronen, Jacob MD*†; Bluvshtein, Vadim MD*; Gelernter, Ilana MA§

doi: 10.1097/01.brs.0000142008.49907.c7
Clinical Case Series

Study Design. Retrospective cohort study.

Objective. To assess neurologic recovery and the manner in which it is affected by various factors following nontraumatic spinal cord lesions (NTSCLs).

Summary of Background Data. NTSCLs comprise a considerable portion of spinal cord lesions. However, information about neurologic recovery in these lesions is scarce.

Method. The study sample included 1,085 patients with NTSCL treated between 1962 and 2000 at the premier referral hospital for rehabilitation in Israel. Demographic and clinical data were collected from hospital charts. The degree of neurologic recovery was determined by comparing each patient's Frankel grades of neurologic deficit at first admission to rehabilitation and at discharge from the same hospitalization. The study population was also compared with previously studied 250 patients with traumatic spinal cord lesions (TSCLs).

Results. Complete or substantial neurologic recovery (upgrade to Frankel Grade D or E) occurred during rehabilitation in 51% of patients who were Grade A, B, or C on admission, and in 57% of those who were Grade C. Neurologic recovery in NTSCL during rehabilitation was significantly affected by initial Frankel grade and by NTSCL etiology. Age had a borderline effect. Gender, lesion level, and the decade of rehabilitation did not affect recovery. Recovery rate was usually higher in NTSCLs than in TSCLs.

Conclusions. The prognosis for neurologic recovery is affected mainly by SCL severity and etiology, and is usually better in NTSCLs than in TSCLs.

A review of 1,085 patients with nontraumatic spinal cord lesions showed good potential for recovery during rehabilitation. Frankel grade D or E was achieved by 51% of patients with Grades A, B, and C on admission, and recovery rate was usually higher in nontraumatic than in previously studied traumatic spinal cord lesions.

From the *Loewenstein Rehabilitation Hospital, Raanana; †Sackler Faculty of Medicine and the §Statistical Laboratory, School of Mathematics, Tel Aviv University, Tel Aviv; and ‡Tel Aviv Medical Center, Tel Aviv, Israel.

Acknowledgment date: February 17, 2003. First revision date: June 3, 2003. Second revision date: October 22, 2003. Acceptance date: November 10, 2003.

Supported by the Unit of Medical Services, Rehabilitation Department, Israel Ministry of Defense.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Institutional funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Amiram Catz, MD, Department IV, Spinal Rehabilitation, Loewenstein Rehabilitation Hospital, 278 Ahuza St., P.O. Box 3, Raanana 43100, Israel; E-mail: amcatz@post.tau.ac.il.

© 2004 Lippincott Williams & Wilkins, Inc.