Rehabilitation of Patients with Nontraumatic Spinal Cord Injury in the Netherlands: Etiology, Length of Stay, and Functional Outcome

Background: Patients with nontraumatic spinal cord injury (NTSCI) are different from patients with traumatic spinal cord injury. A better understanding of the characteristics of NTSCI and their influence on length of stay (LOS) and functional outcome might help professionals in planning rehabilitation and predicting outcomes in NTSCI. Objective: To describe personal and injury characteristics, etiology, LOS, and functional outcome after inpatient rehabilitation in patients with NTSCI. Methods: Retrospective single–center study including 124 patients who were discharged between 2006 and 2010 from their initial inpatient rehabilitation after onset of NTSCI. Information about personal and injury characteristics, LOS, and functional outcome was collected from medical files. Descriptive statistics were performed, and associations between etiology, LOS, and functional outcome were investigated. Results: Fifty percent of participants were male, and mean age was 54.9 years (SD 13.7). Most lesions were classified as American Spinal Injury Association Impairment Scale (AIS) D (68.8%) and paraplegic (76.6%). The most frequent etiologies were degeneration (25.8%), vascular disease (21.8%), benign tumor (16.1%), and malignant tumor (15.3%). Discharge destination was usually a private residence (84.6%). Median LOS in inpatient rehabilitation was 61.0 days (interquartile range [IQR], 38.3–111.8). Median functional status score was 47.5 (IQR, 30–70) at admission and 90 (IQR, 75–100) at discharge. Etiology was a significant predictor of LOS and functional status at admission and discharge, but not of functional improvement during inpatient rehabilitation. Conclusion: Spinal degeneration, tumor, and vascular disease were the most common causes of NTSCI. All etiology groups improved during inpatient rehabilitation.