Upper- and lower-extremity motor recovery after traumatic cervical @entity1566 : an update from the national XXXX database.

@entity3510 @entity1 @entity1688 @entity73 @entity1566
OBJECTIVE: To present upper- (UEMS) and lower-extremity motor score (LEMS) recovery, American @entity3510 @entity73 ( @entity73 ) change, and motor level change in @entity1 with traumatic @entity1688 from the @entity1566 ( @entity1566 ). DESIGN: Longitudinal cohort; follow-up to 1 year. SETTING: U.S. @entity1566 . @entity1 : Subjects (N=1436; age>15y) with @entity1688 with at least 2 examinations, the first within 7 days of injury. Subjects were 80% @entity1 injured by vehicular collisions (44%), falls (30%), sports (12%), and violence (11%). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Change in @entity73 , UEMS, LEMS, and motor levels. RESULTS: From a baseline of 7 days or less, 22% of subjects with @entity73 grade A converted to @entity73 grade B or better by rehabilitation discharge; and 30%, by 1 year, with 8% to @entity73 grade C and 7.1% to grade D. Conversion from complete to motor incomplete was not related to timing of the initial examination (P=.54) or initial neurologic level (P=.96). For @entity73 grade B, 34% remained motor complete, 30% became @entity73 grade C, and 37% became grade D by 1 year. Although 82.5% of those with @entity73 grade C improved to @entity73 grades D and E, mean 1-year UEMS score was only 35 points. UEMS scores in @entity1 with @entity73 grade A increased a mean of 9 to 11 points, except for C1 to C3 and C8 to T1 motor levels (gain, 2-3 points). Motor level was unchanged or ascended in 35% and improved 1 level in 42%, 2 levels in 14%, and more than 2 levels in 9%. Motor zone of partial preservation of 2 segments or more was associated with gain of 2 or more motor levels, with a relative risk of 5.0 (95% confidence interval, 3.2-7.8; P<.001). CONCLUSIONS: More @entity1 with cervical complete @entity1566 may be converting to @entity73 grade D compared with earlier reports. Motor level recovery in those with @entity73 grade A and UEMS recovery in those with @entity73 grade C injuries are potential outcomes for acute clinical trials.
