P.220 Mechanism of injury is associated with neurological outcomes in cervical sensorimotor complete traumatic spinal cord injury

Abstract

Background: There is significant heterogeneity in neurological recovery after complete (ASIA A) traumatic spinal cord injury (tSCI). Neurological recovery is often associated with a conversion to a higher letter grade of the American Spinal Injury Association’s impairment scale (ASIA). The mechanism of injury (MOI) may play a significant role in the primary injury and should be considered for greater precision in care. Methods: We isolated ASIA A cervical tSCI patients from three multicenter prospective randomized controlled trials (NACTN, STASCIS, Sygen). Chi-square test with pairwise comparisons with Bonferroni corrections was performed to compare the proportion of ASIA A patients that converted to a higher ASIA grade between different MOI. Results: We identified 486 complete cervical tSCI patients. For patients who developed tSCI as a result of a fall, a significant proportion converted to a higher ASIA grade by 52 weeks (p = 0.009). For patients who developed tSCI as a result of a sports injury, a significantly smaller proportion did not convert to a higher ASIA grade compared to those that converted (p = 0.034). Conclusions: Due to the difference in outcomes, tSCI patients should be treated differently depending on their mechanism of injury.