Article

Retrospective, longitudinal analysis of motor recovery data from
individuals with cervical (C4-C7) sensorimotor complete spinal cord injury (SCI)
according to the International Standards for Neurological Classification of
Spinal Cord Injury (ISNCSCI). OBJECTIVES: To analyze the extent and patterns of
spontaneous motor recovery over the first year after traumatic cervical
sensorimotor complete SCI. METHODS: Datasets from the European multicenter study
about SCI (EMSCI) and the Sygen randomized clinical trial were examined for
conversion of American Spinal Injury Association (ASIA) Impairment Scale (AIS)
grade, change in upper extremity motor score (UEMS) or motor level, as well as
relationships between these measures. RESULTS: There were no overall differences
between the EMSCI and Sygen datasets in motor recovery patterns. After 1 year, up
to 70% of subjects spontaneously recovered at least one motor level, but only 30%
recovered two or more motor levels, with lesser values at intermediate time
points. AIS grade conversion did not significantly influence motor level changes.
At 1 year, the average spontaneous improvement in bilateral UEMS was 10-11 motor
points. There was only moderate relationship between a change in UEMS and a
change in cervical motor level (r(2)=0.30, P<0.05). Regardless of initial
cervical motor level, most individuals recover a similar number of motor points
or motor levels. CONCLUSION: Careful tracking of cervical motor recovery outcomes
may provide the necessary sensitivity and accuracy to reliably detect a subtle,
but meaningful treatment effect after sensorimotor complete cervical SCI. The
distribution of the UEMS change may be more important functionally than the total
UEMS recovered.

Langue : ANGLAIS