Comparison of health outcomes between traumatic spinal cord and cauda equina injuries

Study design: Registry-based cohort. study Objectives: To compare the outcomes of people who have a traumatic spinal cord injury (SCI) or cauda equina injury (CEI). Setting: Victorian State Trauma System (VSTS), Australia. Methods: People from the Victorian State Trauma Registry (VSTR) with a diagnosis of traumatic SCI below T4 or CEI, with a date of injury from 2010 to December 2022, were included. Participants were divided into two groups; upper motor neuron (UMN) and lower motor neuron (LMN) injury groups. Demographic, injury event, and hospital stay details were extracted. Follow-up was conducted by the registry up to 24-months post injury, and included the World Health Organization Disability Assessment Schedule (WHODAS), EuroQol EQ-5D scale, and return to work. Results: Of the 1,156 participants, 1,113 were categorised as UMN, and 43 as LMN. Within both groups, the demographics were similar. Mixed effect regression modelling of the EQ-5D outcomes over time showed little improvement for both groups. The return to work rate was higher for the LMN injury group at all follow-up time points, with 57% of the UMN injury group returning to work at 24 months post-injury compared to 72% of the LMN injury group. At 24 months post-injury, 63% of people in the UMN injury group reported a WHODAS score equal or greater to ten, compared to 65% in the LMN injury group. Conclusion: In conclusion, the patient demographics within the two groups were similar. Overall quality of life outcomes remained similarly poor over time for both groups, with little improvement.