Disclosures: Lucinda Kurzava Kendall, OMS-IV: No financial relationships or conflicts of interest

Objective: Non-traumatic spinal cord injury (SCI) is highly heterogeneous but often lumped together in research for comparison to traumatic SCI. We aim to more precisely characterize the etiologies of non-traumatic ischemic SCI, detail the anticipated features and outcomes of this rare diagnosis, and compare them to the well-established demographic, clinical, and prognostic features of traumatic SCI.

Design: Systematic Review; standard methods (PRISMA guidelines) Setting : n/a Participants : n/a

Interventions: n/a

Main Outcome Measures: For each ischemic SCI sub-etiology: demographics, risk factors, unique clinical features, prevalence and severity of functional sequelae (motor/sensory dysfunction, neurogenic bowel/bladder, sexual dysfunction, neuropathic pain, spasticity, syrinx formation, DVT, pressure injury), functional outcomes (initial and follow-up AIS/ISNCSCI), and psychosocial outcomes (employment, disposition, mental health) were investigated.

Results: 18 studies of varying quality were identified accumulating data on 814 cases of ischemic SCI. Cases were classified by type of ischemic insult: fibrocartilaginous emboli, atheroemoblism, thromboembolism, hypoperfusion, focal arterial stenosis, and poor collateral circulation. Distinct differences in demographics and risk factors were observed both within ischemic SCI (between sub-etiologies) and between ischemic and traumatic SCI. Furthermore, notable gaps in the literature were identified for many functional outcomes and nearly all psychosocial outcomes for ischemic SCI patients. These data provide novel insights into typical ischemic SCI patient profiles and functional outcomes, permitting us to identify and report rehabilitation-specific and prognostic considerations specific to each ischemic SCI sub-etiology. Furthermore, we contrast these data with well-documented published results in traumatic SCI, highlighting notable differences. Conclusions: Ischemic SCI encompasses numerous sub-etiologies, all of which are vastly understudied, particularly in areas including: functional sequelae, functional outcomes, psychosocial outcomes, and intervention efficacy. Systematic prospective and database review studies are needed to more precisely define prognostic features, rehabilitation considerations, and intervention efficacies to provide adequate guidance, expectation management, prognostication, and treatment development/targeting for patients who experience ischemic SCI.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/ischemic-spinal-cord-injury-variety-demographics-and-outcomes-systematic-review-and-contrast-with-traumatic-spinal-cord-injury/