Poster 186: Degenerative versus traumatic spinal cord injury: an inpatient rehabilitation comparison.

Abstract

Objective: To compare nontraumatic spinal cord injury (SCI) due to musculoskeletal degenerative causes such as spinal stenosis to traumatic SCI. Design: Retrospective chart and database review. Setting: Tertiary care inpatient rehabilitation unit. Participants: 191 consecutive persons with traumatic SCI and 125 consecutive persons with degenerative SCI dismissed from a tertiary care inpatient rehabilitation unit between January 1, 1995, and December 31, 2001. Interventions: Not applicable. Main Outcome Measures: Demographics; level and completeness of injury; rehabilitation length of stay (LOS); admission and discharge FIM™ scores; FIM change; and discharge location. Results: Overall, the etiology of SCI was 31% motor vehicle collision (MVC), 14% falls, 4% sports, 11% other accidents, and 40% degenerative disease. When compared with traumatic SCI, persons with degenerative SCI were older (median age, 72.4y vs 38.8y; P<.0001). Gender distribution was similar for both groups (70% men). Comparison of marital status between the groups nearly reached statistical significance ( P=.052). Degenerative SCI admission FIM scores (71 vs 51, P<.0001) and discharge FIM scores (100 vs 84, P<.0001) were significantly higher than those for traumatic SCI. FIM change (23–24 points) was similar for both groups. Neurologic level of injury was similar between the 2 groups. However, incomplete SCI was more common among persons with degenerative SCI etiologies ( P<.0001). Median rehabilitation LOS was significantly shorter for degenerative SCI than traumatic SCI (14d vs 31d, P<.0001). Discharge location did not differ between the groups. Conclusions: Persons with degenerative SCI differed significantly from those with traumatic SCI. However, they experienced significant improvement in function during inpatient rehabilitation, comparable to that seen in traumatic SCI.