Trends in Rates of ASIA Impairment Scale Conversion in Traumatic Complete Spinal Cord Injury

Neurotrauma Reports, 2020 · DOI: 10.1089/neur.2020.0038 · Published: January 1, 2020

Spinal Cord Injury Neurology Research Methodology & Design

Simple Explanation

This study examines how often people with complete spinal cord injuries (SCI) improve over time. The researchers looked at data from 1995 to 2015 to see if the rate of improvement has changed. They found that the rate of conversion from complete to incomplete injury has been increasing, especially for those with injuries in the neck (tetraplegia).

Study Duration

1995-2015 (20 years)

Participants

2036 subjects with complete SCI

Evidence Level

Not specified

Key Findings

1
There was a strong trend toward increased rates of conversion over time, especially for tetraplegia.
2
Conversion rates for paraplegia were less dramatic than for tetraplegia.
3
Increased odds of converting to incomplete were associated with year of injury, level of injury (Tetra >LPara >HPara), non-violent etiology, and age (older is better).

Research Summary

The study examined trends in the conversion rates of ASIA Impairment Scale (AIS) grades in individuals with traumatic complete spinal cord injury (SCI) between 1995 and 2015. The results showed a significant increase in conversion rates over time, particularly for individuals with tetraplegia (cervical SCI). Factors such as year of injury, level of injury, etiology, and age were found to be related to the likelihood of conversion to incomplete status.

Practical Implications

Clinical Trial Design

Historical control data in clinical trials for SCI should be used with caution and updated regularly to reflect changing conversion rates.

Prognostication

Clinicians should be aware of the improved recovery rates for persons with SCI who initially have clinically complete injuries when discussing prognosis with patients and families.

Personalized Medicine

Biomarkers are needed to enhance the predictive value of clinical exams and identify patient subgroups with similar recovery potential for targeted interventions.

Study Limitations

1
The NSCISC database lacks detailed information on medical, surgical, and rehabilitation treatments, limiting the ability to examine the impact of treatment factors on conversion trends.
2
The number of subjects per 3-year interval declined over time, potentially due to changes in the number of funded centers.
3
The study's ability to confirm the AIS grade classification in the database was limited by the lack of individual sensory dermatome scores and sacral sparing information.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury