Traumatic cauda equina injury (TCEI) is usually caused by spine injury at or below L1 and can result in motor and/or sensory impairments and/or neurogenic bowel and bladder. We examined factors associated with recovery in motor strength, walking ability, and bowel and bladder function to aid in prognosis and establishing rehabilitation goals. The analysis cohort was comprised of persons with acute TCEI enrolled in the Rick Hansen Spinal Cord Injury Registry. Multi-variable regression analysis was used to determine predictors for lower-extremity motor score (LEMS) at discharge, walking ability at discharge as assessed by the walking subscores of either the Functional Independence Measure (FIM) or Spinal Cord Independence Measure (SCIM), and improvement in bowel and bladder function as assessed by FIM-relevant subscores. Age, sex, neurological level and severity of injury, time from injury to surgery, rehabilitation onset, and length of stay were examined as potential confounders. The cohort included 214 participants. Median improvement in LEMS was 4 points. Fifty-two percent of participants were able to walk, and >20% recovered bowel and bladder function by rehabilitation discharge. Multi-variable analyses revealed that shorter time from injury to rehabilitation admission (onset) was a significant predictor for both improvement in walking ability and bowel function. Longer rehabilitation stay and being an older female were associated with improved bladder function. Our results suggest that persons with TCEI have a reasonable chance of recovery in walking ability and bowel and bladder function. This study provides important information for rehabilitation goals setting and communication with patients and their families regarding prognosis.

中文翻译：

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与外伤性马尾神经损伤后运动力量、行走能力以及肠和膀胱功能恢复相关的因素

外伤性马尾神经损伤 (TCEI) 通常由 L1 或 L1 以下的脊柱损伤引起，可导致运动和/或感觉障碍和/或神经源性肠和膀胱。我们检查了与运动力量、行走能力以及肠和膀胱功能恢复相关的因素，以帮助预后和建立康复目标。分析队列由在 Rick Hansen 脊髓损伤登记处登记的急性 TCEI 患者组成。多变量回归分析用于确定出院时下肢运动评分 (LEMS)、出院时步行能力的预测因子，如通过功能独立性测量 (FIM) 或脊髓独立性测量 (SCIM) 的步行子评分评估，通过 FIM 相关子评分评估的肠和膀胱功能的改善。年龄、性别、神经系统水平和损伤严重程度、从损伤到手术的时间、康复开始时间和住院时间被视为潜在的混杂因素。该队列包括 214 名参与者。LEMS 的平均改善为 4 分。52% 的参与者能够走路，> 20% 的参与者通过康复出院恢复了肠道和膀胱功能。多变量分析表明，从受伤到康复入院（开始）的时间较短是步行能力和肠道功能改善的重要预测因素。更长的康复时间和成为老年女性与改善膀胱功能有关。我们的结果表明，患有 TCEI 的人有合理的机会恢复步行能力和肠和膀胱功能。