• C Putz, C Schuld, S Gantz, T Grieser, M Akbar, B Moradi, B Wiedenhöfer, C H Fürstenberg, H J Gerner, and R Rupp.
• Spinal Cord Injury Center, University Hospital Heidelberg, Heidelberg, Germany. cornelia.putz@med.uni-heidelberg.de
• Spinal Cord. 2011 Jun 1; 49 (6): 721-7.

Study DesignClinical cohort study.ObjectiveTo evaluate if the impact of the severity of the trauma as a possible confounding factor influences the neurological and functional recovery in paraplegia during the course of a 6-month follow-up period after injury.SettingSpinal Cord Injury Center, Heidelberg University Hospital, Germany.MethodsA retrospective monocentric analysis, from 2002 to 2008, of the Heidelberg European Multicenter Study about spinal cord injury database was performed. We included 31 paraplegic patients (neurological level T1-T12) who were assigned either to a monotrauma (polytraumaschluessel (PTS) 1) or to a polytrauma (PTS≥2) group. The American Spinal Injury Association Impairment Scale, lower extremity motor score, pin prick, light touch and the spinal cord independence measure (SCIM) were obtained at five distinct time points after trauma. Data were analyzed using Mann-Whitney U-test (α<0.05).ResultsThe changes in lower extremity motor score, pin prick and light touch showed no significant differences in both groups over the whole evaluation period. Polytraumatic paraplegics showed a significantly delayed increase of SCIM between 2 and 6 weeks compared with monotraumatic patients, followed by a quantitative increase in the subitems bladder management, bowel management, use of toilet and prevention of pressure sores between 3 and 6 months (P=0.031). The mean length of primary rehabilitation in the polytrauma group was 5.5 vs 3.6 months in monotrauma.ConclusionsThe prognosis of polytraumatic paraplegics in terms of neurological recovery is not inferior to those with monotrauma. Multiple-injured patients need a prolonged hospital stay to reach the functional outcome of monotraumatic patients.

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