• Charles G Fisher, Vanessa K Noonan, Donna E Smith, Peter C Wing, Marcel F Dvorak, Brian K Kwon, and Brian Kwon.
• Division of Spine, Department of Orthopaedics, University of British Columbia, Vancouver Hospital and Health Sciences Centre, Vancouver, British Columbia, Canada. charles.fisher@vch.ca
• Spine. 2005 Oct 1; 30 (19): 2200-7.

Study DesignA retrospective cohort with cross- sectional follow-up.ObjectivesThe primary objective was to determine motor recovery in patients with complete traumatic spinal cord injury (SCI). Secondary objectives included: 1) determining which factors predict local recovery, 2) assessing functional status using the Functional Independence Measure (FIM), and 3) assessing generic health-related quality of life using the Short Form-36 (SF-36).Summary Of Background DataMotor recovery following complete SCI has been documented in the literature; however, it has been difficult to interpret: 1) spinal shock is often not addressed; 2) the definition of complete SCI has changed over the last 10 years; and 3) few studies differentiate between local neurologic recovery in the zone of partial preservation and neurologic recovery caudal to the lesion.MethodsAll patients admitted to Vancouver Hospital with a complete SCI between 1994 and 2001 were identified and included in the study if they remained complete following the resolution of spinal shock. Minimum 2-year follow-up consisted of an ASIA motor score, an FIM, and the SF-36.ResultsOf 133 patients identified, 94 were eligible and 70 completed follow-up. For the tetraplegic patients, the average ASIA motor score was 11.9 +/- 10.7 on admission and 20.1 +/- 10.8 at follow-up, a change reflecting local recovery only. For the paraplegic patients, the average ASIA motor score was 49.3 +/- 2.4 on admission and 50.6 +/- 1.7 at follow-up.ConclusionsMotor recovery does not occur below the zone of injury for patients with complete SCI. Varying degrees of local recovery can be expected in tetraplegic individuals.

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