Non-traumatic spinal cord lesions: epidemiology, complications, neurological and functional outcome of rehabilitation.

Abstract

Prospective cross-sectional study. To study epidemiology, complication, neurological and functional outcome in non-traumatic spinal cord lesions (NTSCL) after inpatient rehabilitation. Neurological rehabilitation unit of a tertiary research hospital. Sixty-four patients (M/F=28:36) with NTSCL admitted from June 2005 to January 2008 for multidisciplinary rehabilitation. Epidemiology, medical complications during stay in rehabilitation, admission and discharge--Barthel Index (BI) and American Spinal Injury Association (ASIA) impairment scale for functional and neurological recovery, respectively, were recorded and analyzed. NTSCL constituted 60% (64 of 106) of the total SCL patients admitted for rehabilitation during the same period. Female patients outnumbered males (56.25%) in the study. Mean age, duration of illness and duration of stay in rehabilitation were 30.64+/-13.67 years (6-57), 7.09+/-9.15 months (1-48) and 55.75+/-40.91 days (14-193), respectively. The ratio of paraplegia and quadriplegia was 2:1. Forty-four patients (68.75%) had incomplete cord lesion according to the ASIA impairment scale. Spinal tumors (26.6%) were found to be the most common etiology, followed by Pott's spine (25%) and transverse myelitis (22%). Urinary tract infection was found to be the most common complication (50%), followed by spasticity (35.93%) and urinary incontinence (31.25%). The mean BI scores showed significant (P=0.000) functional recovery during rehabilitation using paired Student's t-test. The ASIA impairment scale showed significant neurological recovery (P=0.001) using the Wilcoxon non-parametric test. NTSCL constitute a significant proportion of overall SCL. Female population, paraplegia and incomplete cord lesions are more common among NTSCL in this study. Patients with NTSCL recover significantly both neurologically and functionally with rehabilitation intervention.