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Journal of Neurology and Neurorehabilitation Research | Volume 4
September 03-04, 2019 | London, UK
Spine and Spinal Disorders
4
th
International Conference on
J Neurol Neurorehabil Res, Volume 4
Neurological recovery following Traumatic Spinal Cord injury: A systematic review and
meta-analysis
Richam Faissal El Hossain Ellakkis
Hospital Municipal de Foz do Iguaçu, Brazil
T
his study aims to summarize the current evidence on
neurological recovery following TSCI by use of a meta-
analytical approach, and to identify injury, treatment, and
study variables with prognostic significance.
A literature search in MEDLINE and EMBASE was performed,
and studies reporting follow-up changes in American Spinal
Injury Association (ASIA) Impairment Scale (AIS) or Frankel
or ASIA motor score (AMS) scales were included in the meta-
analysis. The potential effect of severity, level andmechanism
of injury, type of treatment, time and country of study, and
follow-up duration were evaluated using meta-regression
analysis.
A total of 114 studies were included, reporting AIS/Frankel
changes in 19,913 patients andAMS changes in 6920 patients.
The AIS/Frankel conversion rate was 19.3% (95% CI 16.2–
22.6) for patients with grade A, 73.8% (95% CI 69.0–78.4) for
those with grade B, 87.3% (95% CI 77.9– 94.8) for those with
grade C, and 46.5% (95%CI 38.2–54.9) for those with grade D.
Neurological recovery was significantly different between all
grades of SCI severity in the following order: C>B>D>A. Level
of injurywas a significant predictor of recovery; recovery rates
followed this pattern: lumbar > cervical and thoracolumbar >
thoracic. Thoracic SCI and penetrating SCI were signi cantly
more likely to result in complete injury. Penetrating TSCI had a
signi cantly lower recovery rate compared to blunt injury (OR
0.76,95%CI0.62–0.92;p=0.006).Recoveryratewaspositively
correlated with longer follow-up duration (p = 0.001). Studies
with follow-up durations of approximately 6 months or less
reported significantly lower recovery rates for incomplete
SCI compared to studies with long-term (3–5 years) follow-
ups. The authors demonstrated how neurological recovery
after TSCI is significantly dependent on injury factors, but is
not associated with type of treatment or country of origin.
Based on these results, a minimum follow-up of 12 months
is recommended for TSCI studies that include patients with
neurologically incomplete injury.
Speaker Biography
Richam Ellakkis has completed his graduation in Medical School at the
FederalUniversityofMatoGrossodoSulandtheresidenceofNeurosurgery
at Hospital de Base, São José do Rio Preto. Fellowship in Skull Base Tumors
and Neurovascular at University of São Paulo. At present he is living in Foz
do Iguaçu in the position of Neurology and Neurosurgey Coordination at
Hospital Municipal.
e:
richam_e@hotmail.com