411 Traumatic Versus Non-Traumatic Injury in Prognosis of Outcomes After Cervical Spinal Cord Injury

Purpose. This study was conducted primarily to be a descriptive study about non-traumatic (NT) spinal cord injury (SCI) patients, in terms of their demographic and neurological features, and to investigate the complications and efficient results of rehabilitation in this group. The second aim of the study was to conduct a comparison between non-traumatic SCI patients and traumatic SCI patients.Materials and methods. The design was a retrospective study at a Physical Medicine and Rehabilitation Training and Research center. The study was carried out with 194 patients, of whom 63 had non-traumatic SCI and 131 had traumatic SCI. Main outcome measures were: Demographics, etiology, Functional Independent Measure score, and level of injury.Results. A total of 32.47% (n = 63) of the patients in the study had a non-traumatic SCI. In traumatic SCI group, the proportion of male patients were significantly more than the proportion of female patients (p = 0.002). Admission FIM score of non-traumatic SCI group was better than the traumatic SCI group (p = 0.004). The comparison of discharge FIM scores between traumatic SCI and non-traumatic SCI groups did not yield any significant results (p = 0.303). However, the comparison of FIM gain between the two groups showed a significant difference (p = 0.03). The most common complication in non-traumatic SCI group was urinary tract infection and this was observed in 25 patients (39.68%).Conclusions. The present study showed that there are certain differences between NT and traumatic SCI patients. Therefore, not all SCI patients should be considered to be falling under a single category, and should be divided into groups on the basis of the etiology of the injury. It is important to consider this information while developing the targets and planning of the rehabilitation program.

Nontraumatic spinal cord injury: Incidence, epidemiology, and functional outcome

Community cross-sectional self-report survey of adults with spinal cord injury (SCI). The aim of this study was to examine the likelihood of depression, anxiety and stress in adults with non-traumatic SCI (NT-SCI) compared with adults with traumatic SCI (T-SCI). Victoria, Australia. Adults (N=443; NT-SCI n=62) living in the community and attending specialist SCI rehabilitation clinics. Participants completed a self-report survey by internet, telephone or hard copy. Items included demographic and injury-related characteristics and the short form Depression, Anxiety and Stress Scale (DASS-21). Persons with NT-SCI were significantly more likely to be female (P<0.05), older (P<0.001) and have lower-level incomplete injuries (P<0.001). The probability of depression, anxiety or stress in respondents with NT-SCI did not differ from persons with T-SCI (P>0.05). Overall, the prevalence of adverse mental health problems defined by scoring above DASS-21 cutoffs, were depression 37%, anxiety 30%, and clinically significant stress 25%. This study examined multiple mental health outcomes after NT-SCI in Australia. This study provides some evidence that the results of studies of depression, anxiety or stress in persons with T-SCI can be generalised to those with NT-SCI in the post-acute phase. NT-SCI patients are also at substantial risk of poor mental health outcomes. General demographic and injury-related characteristics do not seem to be important factors associated with the mental health of adults with SCI whether the SCI is traumatic or non-traumatic in origin.

Nontraumatic spinal cord injury (SCI) represents a significant proportion of individuals admitted for SCI rehabilitation; however, there is limited literature regarding their outcomes. As our society continues to age and nontraumatic injuries present with greater frequency, further studies in this area will become increasingly relevant. The objective of this study was to compare outcomes of patients with nontraumatic SCI with those with traumatic SCI after inpatient rehabilitation. A longitudinal study with matched block design was used comparing 86 patients with nontraumatic SCI admitted to a SCI rehabilitation unit and 86 patients with traumatic SCI admitted to regional model SCI centers, controlling for age, neurologic level of injury, and American Spinal Injury Association impairment classification. Main outcome measures included acute and rehabilitation hospital length of stay, FIM scores, FIM change, FIM efficiency, rehabilitation charges, and discharge-to-home rates. Results indicate that when compared with traumatic SCI, patients with nontraumatic SCI had a significantly (P < 0.01) shorter rehabilitation length of stay (22.38 vs. 41.35 days) and lower discharge FIM scores (57.3 vs. 65.6), FIM change (18.6 vs. 31.0), and rehabilitation charges ($25,050 vs. $64,570). No statistical differences were found in acute care length of stay, admission FIM scores, FIM efficiency, and community discharge rates. The findings indicate that patients with nontraumatic SCI can achieve rates of functional gains and community discharge comparable with traumatic SCI. Whereas patients with traumatic SCI achieved greater overall functional improvement, patients with nontraumatic SCI had shorter rehabilitation length of stay and lower rehabilitation charges. These findings have important implications for the interdisciplinary rehabilitation process in the overall management and outcome of individuals with nontraumatic SCI.

Study Design:Systematic review.Objective:To evaluate the impact of riluzole on neurobehavioral outcomes in preclinical models of nontraumatic and traumatic spinal cord injury (SCI).Methods:An extensive search of the literature was conducted in Medline, EMBASE, and Medline in Process. Studies were included if they evaluated the impact of riluzole on neurobehavioral outcomes in preclinical models of nontraumatic and traumatic SCI. Extensive data were extracted from relevant studies, including sample characteristics, injury model, outcomes assessed, timing of evaluation, and main results. The SYRCLE checklist was used to assess various sources of bias.Results:The search yielded a total of 3180 unique citations. A total of 16 studies were deemed relevant and were summarized in this review. Sample sizes ranged from 14 to 90, and injury models included traumatic SCI (n = 9), degenerative cervical myelopathy (n = 2), and spinal cord-ischemia (n = 5). The most commonly assessed outcome measures were BBB (Basso, Beattie, Besnahan) locomotor score and von Frey filament testing. In general, rats treated with riluzole exhibited significantly higher BBB locomotor scores than controls. Furthermore, riluzole significantly increased withdrawal thresholds to innocuous stimuli and tail flick latency following application of radiant heat stimuli. Finally, rats treated with riluzole achieved superior results on many components of gait assessment.Conclusion:In preclinical models of traumatic and nontraumatic SCI, riluzole significantly improves locomotor scores, gait function, and neuropathic pain. This review provides the background information necessary to interpret the results of clinical trials on the impact of riluzole in traumatic and nontraumatic SCI.

Background Cervical traumatic spinal cord injury (SCI) is a devastating condition that can result in tetraplegia. Early surgical decompression and rehabilitative efforts in cervical SCI patients has been shown to improve neurological outcomes. In this study, we sought to evaluate the impact of various factors at the time of injury and throughout the rehabilitative period on motor functional independence after 1 and 5 years after injury in patients undergoing cervical spinal cord decompression. Methods A longitudinal, retrospective cohort study from the multicenter spinal cord injury Model Systems (SCIMS) database was conducted on patients who presented between 1998 and 2011 with motor Functional Independence Measure (mFIM) scores at rehabilitation admission (RA) and discharge (DC) from inpatient rehabilitation (IPR), year 1, and year 5. Patients who had undergone surgical decompression with neurological levels of injury limited to the cervical region and those with American Spinal Injury Association (ASIA) Impairment Scale (AIS) grades of A and B were included. The mFIM score was utilized to calculate changes in mFIM (ΔmFIM) scores over each respective time period. Multivariable logistical regression was performed to identify longitudinal predictors associated with functional independence controlling for demographics, SCI etiology and level, vertebral bony fracture/dislocation, associated injuries, AIS grade, and discharge disposition. Results A total of 351 patients were included. A majority were 15–29 years old (53.6%) and 80.1% male. Vehicular-related etiologies (49.9%) were most commonly implicated as the mechanism of cervical SCI. Most patients were AIS grade A at the time of RA (66.4%), with an average time from injury to RA of 19 days (IQR 11–32) for all patients. A total of 131 patients required ventilatory support at the time of RA, and of those, only 12 eventually became FI by year 5. Although the number of patients requiring ventilatory support decreased from 131 to 20 by year 5, no additional patients became FI if they required support at the time of DC or year 1. By 1 year, 43 (12.3%) patients achieved functional independence, and an additional 12 (3.42%) achieved functional independence by year 5. Although those with AIS B injuries (aOR = 5.23, P = 0.0014) and AIS improvement (aOR = 5.14, P = 0.0004) had a greater likelihood of FI by year 1, year 1 FI was more strongly predicted by greater ΔmFIM score during a shorter IPR time period (ΔmFIM score during IPR, aOR = 14.2, P < 0.0001). While AIS grade and AIS improvement were no longer predictive of year 5 FI (P > 0.09 for both), the ΔmFIM score during IPR remained as the strongest predictor towards achieving FI by year 5 (aOR = 23.1, P < 0.0001). Furthermore, a stratified analysis of those patients who did not achieve FI at year 1 revealed that the ΔmFIM score during IPR was an even greater predictor of FI at year 5 (aOR = 53.0, P < 0.0001). A similar relationship was observed where stratification of patients by AIS grade showed that AIS A injuries demonstrated a higher likelihood of 5-year FI due to ΔmFIM score during IPR (aOR = 51.3, P = 0.0002 vs. AIS B: aOR = 42.2, P = 0.0009). Similarly, stratification by need for ventilatory support at RA revealed those who did require ventilatory assistance at RA also had a higher likelihood of 5-year FI due to ΔmFIM score during IPR (aOR = 171, P = 0.035). Conclusion In patients who suffered an AIS A/B cervical SCI, IPR contributed to achieving functional independence in up to 5 years after the inciting injury. By year 1, 12.3% of patients achieved functional independence, and from years 1 to 5, an additional 3.42% of patients achieved functional independence. Although AIS B patients and patients with AIS improvement had improved outcomes at year 1, only the ΔmFIM score during IPR predicted eventual FI status by year 5. Due to the increased likelihood attaining functional independence at year 5 in AIS A SCI, carries emphasized importance for patients who do not attain functional independence by year 1. Our study highlights the crucial role of early and aggressive rehabilitation following surgical intervention toward ultimate functional independence in traumatic cervical SCI patients enduring complete loss of motor function.

(1) To describe functional status, length of stay (LOS) and time to rehabilitation admission trends. (2) To identify independent predictors of motor function following rehabilitation. Retrospective cohort study. Spinal injury rehabilitation unit at King Fahad Medical City, Riyadh, Saudi Arabia. From chart review of 312 traumatic and 106 nontraumatic adult patients with spinal cord injury (SCI) we extracted information on time from injury to rehabilitation admission, rehabilitation LOS, Functional Independence Measure (FIM) motor score (admission and discharge), American Spinal Injury Association Impairment Scale (AIS) grade and demographics. Hierarchical regression was employed to investigate variables associated with discharge FIM motor score for traumatic and nontraumatic SCI. Mean±s.d., median days from injury to rehabilitation admission were 377±855, 150 days for traumatic SCI and 288±403, 176 days for nontraumatic SCI. For individuals with traumatic SCI, after accounting for admission FIM motor score, tetraplegia and time from injury to rehabilitation admission had a significant but small negative association with discharge FIM motor score. For individuals with nontraumatic SCI, increasing age and higher AIS grade had a significant negative association with discharge FIM motor score. Shorter time from injury to rehabilitation admission may improve outcomes for those with traumatic SCI. As time spent in rehabilitation was shorter than in most other countries, a change in practice in this area may be warranted. Developing strategies to improve outcomes for older patients with nontraumatic SCI would also be beneficial.

ObjectivesTo provide a methodological reference paper for the inception cohort of the Swiss Spinal Cord Injury Cohort Study (SwiSCI), by detailing its methodological features and reporting on participant characteristics, response rates and non-response bias.DesignProspective cohort study starting in 2013 in all 4 specialized rehabilitation centres in Switzerland.SubjectsIncluded are 655 newly diagnosed first rehabilitation patients aged ≥16 years with traumatic or non-traumatic spinal cord injury (TSCI, NTSCI).MethodsDescriptive statistics were used to depict participant characteristics and to compare characteristics of responders and non-responders. Logistic regressions were conducted to estimate non-response bias.RESULTSThe sample consisted of 69% males, with mean age 53.5 years, 57.9% TSCI, 60.7% paraplegia and 78.8% incomplete SCI. Males and younger persons more often sustained TSCI and more severe SCI, resulting in longer duration of rehabilitation. Complete lesions were more prevalent in TSCI compared to NTSCI. The response rate was 47.5% and study participation was less likely in females, older persons, persons with lower functional independence and those with NTSCI.ConclusionSwiSCI inception cohort data enable the estimation of epidemiological figures of SCI in Switzerland, and prognostic and trajectory modelling of outcomes after SCI to guide policy, service provision and clinical practice.LAY ABSTRACTThe inception cohort of the Swiss Spinal Cord Injury Cohort Study (SwiSCI) is a prospective study including newly diagnosed first rehabilitation patients aged over 16 years with traumatic or non-traumatic spinal cord injury (SCI) who received first rehabilitation in a specialized center in Switzerland. This paper describes the methods and the design of the SwiSCI inception cohort and reports on participant characteristics, response rates and differences between respondents and non-respondents. The response rate was 47.5% and 655 patients participated in the study. Of participants, 69.0% were male, mean age was 53.5 years, 57.9% had traumatic SCI, 60.7% paraplegia and 78.8% incomplete SCI. Male subjects and younger persons more often sustained traumatic SCI and more severe SCI, resulting in longer duration of rehabilitation. Complete lesions were more prevalent in traumatic SCI compared with non-traumatic SCI. Females, older persons, persons with lower functional independence and those with non-traumatic SCI were less likely to participate in the study.

Multi-centre prospective descriptive study. To establish a profile of the population affected with traumatic and non-traumatic spinal cord injury (SCI) admitted to rehabilitation centres in the Netherlands and Flanders (Belgium) and to describe determinants of length of stay (LOS) and functional outcome. Eleven rehabilitation centres in the Netherlands and Flanders. A total of 919 patients with traumatic and non-traumatic SCI on first admission to rehabilitation centres between 2002 and 2007. Information about LOS, functional outcome and personal and injury characteristics was derived from a joint data set developed for this project. A total of 54.7% of patients with SCI had a non-traumatic lesion. The group of patients with non-traumatic SCI showed a more even gender distribution, a more advanced age and less severe lesion characteristics than the group of patients with traumatic SCI. Linear regression models explained 32% of the variance of LOS and 42% of the variance of functional outcome. Functional status on admission was the strongest determinant of LOS and completeness of the lesion was the strongest determinant of functional outcome. Aetiology (traumatic versus non-traumatic) was a weak independent determinant of LOS but was not an independent determinant of functional outcome. Patients with non-traumatic SCI formed a majority in the Dutch and Flemish SCI population. Although the characteristics of patients with traumatic and non-traumatic SCI clearly differed, rehabilitation of patients with non-traumatic SCI appears at least as efficient as rehabilitation of patients with traumatic SCI.

Retrospective case review. To compare the rehabilitation outcomes between patients with traumatic spinal cord injuries and patients with non-traumatic spinal cord injuries, using The Needs Assessment Checklist (NAC), to observe if both the groups benefit from the same rehabilitation programme. Tertiary care, spinal cord injury rehabilitation unit (National Spinal Injuries Centre), Stoke Mandeville Hospital, UK. Information obtained with the NAC at two time points during patients' rehabilitation was examined. Statistical analysis investigated the rehabilitation outcomes both between and within groups. Initial differences were observed on admission between patients with traumatic and non-traumatic spinal cord injuries in five of the ten rehabilitation domains measured, with patients with non-traumatic injuries presenting with better outcomes. At a later stage in patients' rehabilitation, however, differences between the groups had lessened. Furthermore, the results demonstrated that the whole cohort made significant improvements in all the ten rehabilitation domains, with the same finding evident for both patients with traumatic and patients with non-traumatic spinal cord injuries. Patients with traumatic spinal cord injuries and patients with non-traumatic spinal cord injuries benefitted from the same rehabilitation programme in a spinal injury centre, making significant improvements in all ten rehabilitation domains measured, suggesting that it is effective to admit and rehabilitate patients with injuries resulting from both traumatic and non-traumatic aetiologies in the same specialised setting.

Pressure ulcers (PUs) are common complications in patients with complete spinal cord injury (SCI) or incomplete SCI in which sensory function is spared. Most studies analyzing associated factors of PU and SCI have been performed in cases of traumatic SCI and in just a few cases of nontraumatic SCI. This study was designed to look specifically at the differences in causative factors of PU in cases of traumatic and nontraumatic SCIs. The authors performed a retrospective, cross-sectional study evaluating patients with complete and incomplete SCIs (American Spinal Injury Association Grades A and B) under the coverage of the financial, medicosocial, and rehabilitative support provided by the State Welfare Organization of Iran (SWOI). There were 3791 cases of traumatic SCI (63.2%) and 2110 cases of nontraumatic SCI (35.2%). For 94 patients (1.6%), sufficient data were not available. A PU was detected in 39.2% of all patients with an SCI (71.8% of those with traumatic SCI vs 28.2% of those with nontraumatic SCI). A univariate analysis showed a significant association between occupation, education, and the presence of PU in patients with a traumatic SCI (p < 0.05). This contrasted with nontraumatic SCI in which an association between PU and age was noted (p < 0.05). Using logistic regression, traumatic cause, older age, an interval less than 1 year since the onset of SCI, male sex, and single status were found to significantly increase the risk of PU in all patients with an SCI. However, a higher education level had a preventive effect on PU. This study revealed some risk factors for PU in the authors' setting. The authors' findings suggest a possible difference between the risk factors for PU in patients with both types of SCI. Further study on the pathoetiology of these differences is paramount in the future.

Study designLongitudinal study.ObjectiveTo explore whether individuals with traumatic spinal cord injury (TSCI) and non-traumatic SCI (NTSCI) experience different trajectories in changes of cardiometabolic disease (CMD) factors during initial rehabilitation stay.SettingMulticenter Swiss Spinal Cord Injury Cohort (SwiSCI) study.MethodsIndividuals without history of cardiovascular diseases were included. CMD factors and Framingham risk score (FRS) were compared between TSCI and NTSCI. Linear mixed models’ analysis was employed to explore the trajectory in CMD factors changes over rehabilitation period and a multivariate linear regression analysis was used at discharge from inpatient rehabilitation to explore factors associated with CMD risk profile in TSCI and NTSCI. We performed age and sex-stratified analyses.ResultsWe analyzed 530 individuals with SCI (64% with TSCI and 36% NTSCI). The median age was 53 years (IQR:39-64) with 67.9% (n = 363) of the study cohort being male. The median rehabilitation duration was 4.4 months (IQR 2.4-6.4). At admission to rehabilitation, FRS (9.61 vs. 5.89) and prevalence of hypertension (33.16% vs. 13.62%), diabetes (13.68% vs. 4.06%), and obesity (79.05% vs. 66.67%) were higher in NTSCI as compared to TSCI, No difference was observed in cardiometabolic syndrome between the groups (around 40% in both groups). Overall, we observed longitudinal increases in total cholesterol, HDL-C and HDL/total cholesterol ratio, and a decrease in fasting glucose over the rehabilitation period. No differences in longitudinal changes in cardiovascular risk factors were observed between TSCI and NTSCI.ConclusionsThere was no deterioration in cardiometabolic risk factors over rehabilitation period, at discharge from initial rehabilitation stay. Both TSCI and NTSCI experienced high burden of cardiometabolic syndrome components with NTSCI experiencing more disadvantageous risk profile. The effectiveness of therapeutic and lifestyle/behavioral strategies to decrease burden of cardiometabolic disease and its components in early phase should be explored in future studies.

&lt;p dir="ltr"&gt;The global prevalence of spinal cord injury (SCI) is approximately 230-1300 cases per million populations per year and the estimated rate worldwide is 250,000 - 500,000 individuals per year. Preventable causes (traffic accidents and falls) are reported as the major cause of SCI. Fall is the most common cause of SCI in the elderly and compared to previous studies the mean age of individuals with SCI is now higher. No definite curative treatment is at the time available and depending on the extend and the level of the injury in the spinal cord the long-term neurological outcomes may differ considerably. Spinal cord infarction is an uncommon condition, with no available established diagnostic criteria at the time, no clearly clarified aetiology and despite the similarities to cerebral stroke, the implication of vascular risk factors in the pathophysiology of the condition is still not yet entirely understood. In traumatic SCI, the identification of predictors of long-term neurological outcome is crucial in the context of enabling the physician in decision-making regarding treatment strategies and rehabilitation approaches. Factors affecting quality of life in the aftermath of SCI are poorly understood. This thesis aims to study population-based cohorts with traumatic and nontraumatic SCI and to shine a new perspective by offering a fresh viewpoint to some of these questions.&lt;/p&gt;&lt;p dir="ltr"&gt;Study I analyzed the baseline findings and evaluated the long-term outcome for individuals with spinal cord infarction (SCInf), both spontaneous and periprocedural. T2-weighted and diffusion-weighted (DWI) MRI were instrumental imaging techniques for the definite setting of diagnosis. The retrospective application of the recently presented diagnostic algorithm favors the general adoption of the proposed diagnostic criteria. The overrepresentation of vascular risk factors compared with the general population, points out their role in the pathophysiology of the condition. In cases of spontaneous SCInf, a more favorable outcome was observed compared to the periprocedural cases which furthermore were more extensive compared to the spontaneous cases that in turn, to a great degree, affected a single segment of the spinal cord. The neurological improvement shown at long-term follow-up draws special attention to the meaningfulness of active rehabilitation.&lt;/p&gt;&lt;p dir="ltr"&gt;Study II, a systematic analytic review of the current literature on spontaneous SCInf, revealed that in 72% of the cases, although the exact pathophysiology is yet to be understood, at least one vascular risk factor was documented, thus underlying the importance of proper prophylactic management of factors such as hypertension, diabetes, hyperlipidemia and smoking in the context of stroke prevention. Potential to functional recovery was good and ability to walk with or without aids was reported in 71% of the cases, at approximately three years after spontaneous SCInf. Additionally, the introduction of DWI in the diagnostic work-up of SCInf is a valuable tool assisting in the definite diagnosis-setting.&lt;/p&gt;&lt;p dir="ltr"&gt;Study III evaluated the impact of SCI on health-related quality of life (HRQoL) in patients that underwent surgery for traumatic subaxial spine injury. The patient- reported outcome measures (PROMs), specifically EQ-5D-3L and Neck Disability Index (NDI), were studied for the period 2006-2016. Source of data was the Swedish Spine Registry (Swespine). Analysis of PROMs at long-term follow-up times at 1-, 2- and 5-years post-surgery, revealed that the presence and the extend of SCI had negative impact on both outcome measures and that the Frankel grade scale (a classification of the extent of the neurological - functional impairment) was a significant predictor of PROMs. Additionally, analysis of PROMs results at follow-ups beyond 1-year post-surgery showed altogether no significant changes, regardless the extend of the SCI.&lt;/p&gt;&lt;p dir="ltr"&gt;Study IV evaluated long-term follow-up for patients treated surgically for posttraumatic tethered cord syndrome and demonstrated that in the largest part of the patients, the surgical treatment either resulted in improvement of the neurological function or discontinued the neurological decline.&lt;/p&gt;&lt;p dir="ltr"&gt;Study V evaluated retrospectively the long-term outcome and the predictors for neurological recovery in patients with cervical spinal cord injury by analyzing a decade's volume of data from a single, specialized care unit in Stockholm, Sweden. The extend of the initial SCI was a significant predictor for neurologic recovery and regaining of ambulation ability. The median age of the cohort was 64 years, displaying a shift toward an aging population being affected by cervical SCI. Old age was a negative prognostic factor associated with decreased recovery potential. The observed neurological improvement at follow-up underlined the potential for favorable outcome and illustrated the key role of tailored rehabilitative interventions in boosting patient outcomes. In that context, specialized rehabilitation strategies for the more vulnerable and frail older individuals, often presenting with pre-existing comorbidities, might prove to be beneficial and lead to improved functional outcome.&lt;/p&gt;&lt;p dir="ltr"&gt;Study VI, a qualitative study based on semi-structured interviews, evaluated the subjective factors that have impact on quality of life (QoL) in individuals with SCI. Important parameters with impact on well-being were the management of SCI- related physical problems, desire to live an independent life and, the significance of community and a sense of belonging. Contrarily, long-term complications after SCI, especially pain, have a negative impact on QoL and underline the need for further research to enhance treatment options.&lt;/p&gt;&lt;p dir="ltr"&gt;In conclusion, the findings of this thesis, draw attention to the role of MRI imaging techniques for the setting of the diagnosis of SCInf and turn the spotlight on the role of vascular risk factures in the pathophysiology of the condition. The periprocedural cases of SCInf were more extensive and were associated with less favorable outcome compared to the spontaneous cases. In subaxial traumatic cervical injuries, the presence of associated SCI and its severity had a negative impact on the HRQoL based on patient-reported outcomes measures. The potential for neurological improvement in the aftermath of traumatic cervical spinal injury, emphasized the key role of tailored rehabilitative interventions, especially for the more vulnerable older individuals. Components such as autonomy, management of long-term complications and the sense of belonging in the community, carry instrumental positive weight on QoL of individuals with SCI.&lt;/p&gt;&lt;h3&gt;List of scientific papers&lt;/h3&gt;&lt;p dir="ltr"&gt;I. Long-term outcomes after periprocedural and spontaneous spinal cord Infarctions: a population-based cohort study. &lt;b&gt;Stenimahitis V,&lt;/b&gt; Fletcher-Sandersjöö A, El-Haj VG, Hultling C, Andersson M, Sveinsson O, Elmi-Terander A, Edström E. Neurology. 2023 Jul 11;101(2):e114-e124. &lt;a href="https://doi.org/10.1212/wnl.0000000000207377" rel="noreferrer" target="_blank"&gt;https://doi.org/10.1212/wnl.0000000000207377&lt;/a&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;II. Spontaneous spinal cord infarction: a systematic review. Gharios M, &lt;b&gt;Stenimahitis V,&lt;/b&gt; El-Hajj VG, Mahdi OA, Fletcher-Sandersjöö A, Jabbour P, Andersson M, Hultling C, Elmi-Terander A, Edström E. BMJ Neurol Open. 2024 May 28;6(1):e000754. &lt;a href="https://doi.org/10.1136/bmjno-2024-000754" rel="noreferrer" target="_blank"&gt;https://doi.org/10.1136/bmjno-2024-000754&lt;/a&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;III. The effect of concomitant spinal cord injury on postoperative health-related quality of life after traumatic subaxial cervical spine injuries: a nationwide registry study. El-Haj VG, &lt;b&gt;Stenimahitis V,&lt;/b&gt; Singh A, Blixt S, Edström E, Elmi-Terander A, Gerdhem P. Arch Phys Med Rehabil. 2024 Jun;105(6):1069-1075. &lt;a href="https://doi.org/10.1016/j.apmr.2024.01.021" rel="noreferrer" target="_blank"&gt;https://doi.org/10.1016/j.apmr.2024.01.021&lt;/a&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;IV. Long-term outcome following surgical treatment of posttraumatic tethered cord syndrome: a retrospective population-based cohort study. &lt;b&gt;Stenimahitis V,&lt;/b&gt; Fletcher-Sandersjöö A, Tatter C, Elmi-Terander A, Edström E. Spinal Cord. 2022 Jun;60(6):516-521. &lt;a href="https://doi.org/10.1038/s41393-022-00752-7" rel="noreferrer" target="_blank"&gt;https://doi.org/10.1038/s41393-022-00752-7&lt;/a&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;V. Long-term outcome and predictors of neurological recovery in cervical spinal cord injury: a population-based cohort study. &lt;b&gt;Stenimahitis V,&lt;/b&gt; Gharios M, Fletcher-Sandersjöö A, El-Hajj VG, Singh A, Buwaider A, Andersson M, Gerdhem P, Hultling C, Elmi-Terander A, Edström E. Sci Rep. 2024 Sep 9;14(1):20945. &lt;a href="https://doi.org/10.1038/s41598-024-71983-2" rel="noreferrer" target="_blank"&gt;https://doi.org/10.1038/s41598-024-71983-2&lt;/a&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;VI. Quality of life after spinal cord injury: a qualitative interview-based study. &lt;b&gt;Stenimahitis V,&lt;/b&gt; Guenna Holmgren A, El-Hajj VG, Hultling C, Elmi-Terander A, Edström E. [Manuscript]&lt;/p&gt;

Depression in Individuals With Traumatic and Nontraumatic Spinal Cord Injury Living in the Community

Background: Understanding of the underlying mechanisms of Spinal cord injury (SCI) would help in the development of treatment strategies and enhance neurological recovery. Aim: The aim of this study was to describe clinical and demographic data of SCI in a physical medicine department and to compare neurological and functional outcome in Traumatic Spinal Cord Injury group (TSCI) and Non Traumatic Spinal Cord Injury group (NTSCI) during two years of follow up. Materials and methods: This study was conducted in a physical medicine and rehabilitation department of a tertiary hospital (January 2008-December 2014). Medical records of 177 patients with spinal cord injury (SCI) were reviewed. Two groups were defined: traumatic (TSCI) and non-traumatic (NTSCI) spinal cord injury. Characteristics and functional outcome were analyzed and compared. Results: Patients of NT group were significantly older. Most of injuries in both groups had a cervical level. ASIA scale scores and MIF scales were significantly higher in NT group at admission and after two years of follow up. The impairment was more remarkable in this group. Conclusions: Our study suggests that non traumatic SCI represent a considerable proportion of SCI rehabilitation admissions. Although different characteristics and injury patterns, functional outcomes maybe comparable to traumatic SCI. Key words: spinal cord injury, epidemiology, etiology, rehabilitation