Evidence map›Paper›PMID 32066872›Full record

ArticleSpinal cord2020

Neurological recovery after traumatic spinal cord injury: what is meaningful? A patients' and physicians' perspective.

Paula Valerie Ter Wengel, Marcel W M Post, Enrico Martin, Janneke Stolwijk-Swuste, Allard Jan Frederik Hosman, Said Sadiqi, William Peter Vandertop, Fetullah Cumhur Öner

Abstract read
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Article in Spinal cord, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Paula Valerie Ter WengelDepartment of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands. v.ter.wengel@haaglandenmc.nl.
Marcel W M PostCenter of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.ORCID http://orcid.org/0000-0002-2205-9404
Enrico MartinDepartment of Plastic and Reconstructive Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Janneke Stolwijk-SwusteCenter of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
Allard Jan Frederik HosmanDepartment of Orthopedic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Said SadiqiDepartment of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
William Peter VandertopDepartment of Neurosurgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0001-5417-0265
Fetullah Cumhur ÖnerDepartment of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designCross-sectional survey.

objectivesMost studies on neurological recovery after traumatic spinal cord injury (tSCI) assess treatment effects using the American Spinal Injury Association Impairment Scale (AIS grade) or motor points recovery. To what extent neurological recovery is considered clinically meaningful is unknown. This study investigated the perceived clinical benefit of various degrees of neurological recovery one year after C5 AIS-A tSCI.

settingThe Netherlands.

methodsBy means of a web-based survey SCI patients and physicians evaluated the benefit of various scenarios of neurological recovery on a scale from 0 to 100% (0% no benefit to 100% major benefit). Recovery to AIS-C and D, was split into C/C+ and D/D+, which was defined by the lower and upper limit of recovery for each grade.

resultsA total of 79 patients and 77 physicians participated in the survey. Each AIS grade improvement from AIS-A was considered significant benefit (all p < 0.05), ranging from 47.8% (SD 26.1) for AIS-B to 86.8% (SD 24.3) for AIS-D+. Motor level lowering was also considered significant benefit (p < 0.05), ranging from 66.1% (SD 22.3) for C6 to 81.7% (SD 26.0) for C8.

conclusionsMeaningful recovery can be achieved without improving in AIS grade, since the recovery of functional motor levels appears to be as important as improving in AIS grade by both patients and physicians. Moreover, minor neurological improvements within AIS-C and D are also considered clinically meaningful. Future studies should incorporate more detailed neurological outcomes to prevent potential underestimation of neurological recovery by only using the AIS grade.

Indexed as

Attitude of Health PersonnelHealth Knowledge, Attitudes, PracticeInjury Severity ScoreAdultCross-Sectional StudiesFemaleHumansMaleMiddle AgedRecovery of FunctionSpinal Cord Injuries

Identifiers

PMID32066872

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.