Impact of associated conditions resulting from spinal cord injury on health status and quality of life in people with traumatic central cord syndrome

Vanessa K Noonan, Jacek A Kopec, Hongbin Zhang, Marcel F Dvorak
Archives of Physical Medicine and Rehabilitation 2008, 89 (6): 1074-82

OBJECTIVE: To determine the effect of associated spinal cord injury (SCI) conditions on the health status and quality of life (QOL) in people with traumatic central cord syndrome.

DESIGN: Cross-sectional design.

SETTING: Community-based.

PARTICIPANTS: Subjects (N=70) with traumatic central cord syndrome who were a minimum of 2 years postinjury.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Presence of associated SCI conditions (neuropathic pain, spasticity, bowel, bladder, and/or sexual dysfunction, decreased motor function); health status (36-Item Short-Form Health Survey [SF-36], symptom satisfaction); and QOL.

RESULTS: The SF-36 physical component score (PCS) was lower in subjects who reported problems with bowel, bladder, and/or sexual function (-6.9; 95% confidence interval [CI], -11.6 to -2.2). The PCS was decreased in subjects with a lower motor score and this relationship was negatively affected by spasticity and being less educated. The SF-36 mental component score was negatively affected by neuropathic pain and a lower motor score. Neuropathic pain and a lower motor score were both associated with subjects being dissatisfied with their symptoms. Subjects who had a higher motor score were more likely to have a higher QOL (odds ratio, 1.7; 95% CI, 1.1 to 2.7).

CONCLUSIONS: The associated SCI conditions bowel, bladder, and/or sexual dysfunction, neuropathic pain, decreased motor function, and spasticity negatively affect the health status of persons with traumatic central cord syndrome. Diminished motor recovery was the only associated SCI condition to impact QOL. By developing a conceptual model and adjusting for confounders, an estimate for each associated SCI condition's effect on patient outcomes was obtained. Our results indicate the importance of treating or ameliorating associated SCI conditions in order to maximize physical and mental functioning.

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