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Prognosis

Authoring team

In the long term, spinal cord injury is associated with multiple medical (pressure ulcers, pneumonia, atelectasis, and others), urinary (autonomic dysreflexia, neurogenic bladder, and others), and neurological complications in addition to pain

  • neuropathic pain occurs in 40% of people with spinal cord injury. It can be severe and disabling, and in people with spinal cord injury it can lead to further impairment of function (1)
  • chances of neurological recovery and improvement are different in different patients and depend on various factors, including primary neurological state, trauma mechanism, vertebral fracture type and location, and age
    • poor prognostic factors include:
      • complete spinal cord injury,
      • older age,
      • thoracic fractures, and fractures accompanied by dislocations
    • amongst all of these factors, the extent of neurological deficits (mostly based on the American Spinal Injury Association [ASIA] classification (2)) has been considered the most important predictive factor for functional outcome and prognosis
    • of patients with complete SCI early after injury
      • 5%-20% will experience improvement to some extent (3);
        • the figure is higher in incomplete lesions, albeit possibly over a very prolonged period after injury

Reference:

  • NICE (February 2016). Spinal Injury
  • American Spinal Injury Association. International standards for the neurological classification of spinal cord injury. Atlanta: American Spinal Injury Association; 2011.
  • Karamouzian S, Saeed A, Ashraf-Ganjouei K, Ebrahiminejad A, Dehghani MR, Asadi AR. The neurological outcome of spinal cord injured victims of the Bam earthquake, Kerman, Iran. Arch Iran Med. 2010;13:351-354

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