[Non-Traumatic Spinal Cord Injury in the Hospital Setting: Functional Profile and Care Pathways in Rehabilitation].
Abstract
INTRODUCTION Non-traumatic spinal cord injury (NTSCI) is an increasingly common clinical condition, particularly among patients with cancer and multiple comorbidities. However, most established care pathways have been developed for acute traumatic spinal cord injury.
Objective
To describe the clinical and functional characteristics of patients with non-traumatic spinal cord injury assessed by a Rehabilitation Department in a tertiary care hospital and to characterize their rehabilitation care pathways.
Materials And Methods
A retrospective observational study was conducted. All inpatient rehabilitation consultations performed between January 2020 and August 2021 were reviewed. Adult patients with a confirmed diagnosis of non-traumatic spinal cord injury were included. Sociodemographic characteristics, etiology, American Spinal Injury Association (ASIA) Impairment Scale classification, functional status, complications, and discharge destination were collected.
Results
Among 2,156 inpatient rehabilitation consultations, 34 patients (1.6%) were diagnosed with non-traumatic spinal cord injury. The mean age was 57.8 ± 15.2 years, and 29.4% were women. The etiology was oncological in 82.4% of cases, mainly related to metastatic spinal disease. Most injuries were incomplete (91.2%), and ASIA grade D was the most frequent neurological impairment (67.6%). In 79.4% of patients, spinal cord injury was not explicitly documented as the reason for referral at the time of consultation. The mean Barthel Index score was 37.4 ± 32.8. Only 8.8% of patients were referred to specialized rehabilitation units.
Conclusions
Non-traumatic spinal cord injury, predominantly of oncological origin and usually incomplete, represents a frequent clinical condition in the hospital setting. Our findings suggest opportunities to improve its early recognition and facilitate timely access to specialized rehabilitation services.