Predicting outcomes following cervical spine trauma

Abstract

Outcome prediction is fundamental for patients with spinal cord injury (SCI) to allow correct counselling of patients and their families and to determine resource allocation during and after rehabilitation immediately after the lesion. Furthermore, knowledge of the natural history of SCI is mandatory to project and assess the results of clinical trials.Thus, the aim of this narrative review was to provide a clear picture of the neurological and functional outcomes of subjects with cervical SCI.This review was based on MEDLINE, EMBASE, SCOPUS, Web of Science, and the Cochrane Central Register of Controlled Trials databases. The following search terms were used: prognosis prediction, SCI, tetraplegia/quadriplegia, neurologic recovery, and ambulation/gait/walking recovery. All article types of the manuscript were included with the exception of animal studies and studies in languages other than English.Both neurological and functional recovery could be prognosticated by the severity of the lesion as assessed by radiological findings and the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). The effect of other factors (such as age, gender and presence of specific syndromes) is also discussed in relation to neurologic and walking recovery.