Middle and long term functional prognosis follow-up in patients with spinal cord stab injury

English Keywords:Spinal cord stab injury  Rehabilitation  ASIA  Medium and long term follow-up  Syringomyelia

English Abstract:

  【Abstract】 Objectives: To investigate the middle and long term prognosis of patients with spinal cord stab injury, and to provide evidence for clinical and rehabilitation practice. Methods: From January 2002 to December 2016, a total of 61 patients with spinal cord stab injury in China Rehabilitation Research Center were enrolled with an average age of 28.9±11.7（8-53）years old. 15 were with cervical spinal cord injury, 39 with thoracic and 7 with lumbosacral spinal cord. All received comprehensive rehabilitation. The follow-up time was 8.6±5.4 years (2-30 years) in average. The international standards published by American Spinal Cord Injury Association(ASIA) were used to evaluate the neurological function of patients at 1 month, 3 months, 6 months, 1 year and more than 2 years after stab injury. The ASIA standards included ASIA impairment scale(AIS), ASIA motor score(AMS), light touch(LT) as well as pin prick(PP). Number of patients in different AIS grades at more than 2 years and 1 month was compared by using χ2 test. AMS, LT, PP were divided into 5 groups according to the different follow-up time and t-test was used. Magnetic resonance imaging(MRI) data were collected to identify syringomyelia. Results: Number of patients in different AIS grades at 1 month was 21 in grade A, 16 in grade B, 7 in grade C while 17 in grade D; AIS score at more than 2 years was 16 in grade A, 9 in grade B, 11 in grade C, 24 in grade D while 1 in grade E. AMS, LT, PP scores at 1 month were 57.6±22.5, 69.9±25.2, 68.0±25.3; 60.8±23.1, 71.5±25.3, 70.0±25.1 at 3 months; 68.3±23.2, 74.9±24.9, 72.9±24.7 at 6 months; 1 year were 69.6±23.2, 75.3±25.1, 73.2±24.8; 67.9±23.4, 73.7±26.1, 71.7±26.2 at more than 2 years. There was no statistic difference(P>0.05) of patients number in different AIS grades at 1 month and at more than 2 years; while there was statistic difference(P<0.05) in group 1 month vs 3 months and group 3 months vs 6 months in AMS, LT and PP. There was no statistic difference (P>0.05) in group 6 months vs 1 year and group 1 year vs 2 years in AMS, LT and PP. The occurrence rate of syringomyelia after spinal cord stab injury was 31.58%(6/19), which was discovered from 2 months to 10 years after injury. No death was discovered during follow-up. Conclusions: The improvement of neurological function in patients with spinal cord stab injury mostly occurred within 6 months after injury, and the neurological function improvement tends to be stable as time goes by, while some patients showed syringomyelia.