Traumatic vs non-traumatic spinal cord lesions: comparison of neurological and functional outcome after in-patient rehabilitation

Study design: Retrospective comparative study of 2 years duration. Objectives: To compare neurological and functional outcome and length of stay of persons with traumatic vs non-traumatic spinal cord lesion (SCL) after in-patient rehabilitation. Setting: Neurological rehabilitation department of a tertiary research center in Bangalore, Karnataka, India. Methods: Seventy-six in-patients with spinal cord lesion: traumatic (38 patients, M/F 34: 4) and non-traumatic (38 patients, M/F 16: 22) were admitted for in-patient multidisciplinary neurorehabilitation. ASIA impairment scale, duration of stay ( DOS), and admission and discharge-Barthel Index scores in both the groups were recorded, compared and analyzed. Results: ASIA impairment scale scores were significantly higher in non-traumatic group both at admission and discharge (P = 0.020 and 0.017), respectively, showing lesser impairment in non-traumatic group. DOS for rehabilitation was higher for traumatic group as compared to non-traumatic group (65.97 +/- 47.66 vs 60.68 +/- 45.69 days), although statistically not significant (P>40.05). Barthel Index scores were 28.68 +/- 17.15 vs 27.63 +/- 14.96 at admission and 54.21 +/- 25.10 vs 51.44 +/- 19.86 at discharge in traumatic and non-traumatic groups, respectively. All patients (n = 76) showed significant improvement in Barthel Index (P=0.000), but no statistically significant difference (P>40.05) was recorded between the two groups, both at admission and at discharge. Orthoses was required significantly more frequently (P=0.043) in traumatic SCL group. Conclusions: The study showed that despite more impairment in persons with traumatic spinal cord lesion, there was statistically no significant difference in the length of stay and the functional outcome between persons with traumatic and non-traumatic spinal cord lesion after in-patient rehabilitation.