Neurological Recovery Trajectories in Older Patients with Cervical Spinal Cord Injury: A Multicenter Longitudinal Study.

Authors

Ryosuke Hirota, Yoshinori Terashima, Makoto Emori, Atsushi Teramoto, Noriaki Yokogawa, Takeshi Sasagawa, Hiroaki Nakashima, Naoki Segi, Sadayuki Ito, Toru Funayama, Fumihiko Eto, Akihiro Yamaji, Kota Watanabe, Satoshi Nori, Kazuki Takeda, Takeo Furuya, Atsushi Yunde, Hideaki Nakajima, Tomohiro Yamada, Tomohiko Hasegawa, Hidenori Suzuki, Yasuaki Imajo, Shota Ikegami, Masashi Uehara, Hitoshi Tonomura, Munehiro Sakata, Ko Hashimoto, Yoshito Onoda, Nobuyuki Suzuki, Kenji Kato, Hiroshi Uei, Hirokatsu Sawada, Kazuo Nakanishi, Kosuke Misaki, Hidetomi Terai, Koji Tamai, Akiyoshi Kuroda, Gen Inoue, Yoichi Iizuka, Eiji Takasawa, Koji Akeda, Norihiko Takegami, Haruki Funao, Yasushi Oshima, Takashi Kaito, Daisuke Sakai, Toshitaka Yoshii, Shoji Seki, Seiji Okada, Shiro Imagama, Satoshi Kato

Published in

Spine surgery and related research. Volume 10. Issue 5. Pages 693-701. Sep 27, 2026. Epub Jun 23, 2026.

Abstract

This study aimed to characterize neurological recovery trajectories in patients with cervical spinal cord injury, aged ≥65 years.
This retrospective multicenter cohort study used registry data from the Japan Association of Spine Surgeons with Ambition. Patients aged ≥65 years with traumatic cervical spinal cord injury and complete International Standards for Neurological Classification of Spinal Cord Injury motor score data at baseline, 6 weeks, and 6 months post-injury, were included (n=222). Neurological assessments included total, upper extremity, and lower extremity motor scores; the American Spinal Injury Association Impairment Scale (AIS) and motor zone of partial preservation. Motor recovery and AIS conversion were analyzed based on baseline and 6-week AIS grades.
Motor recovery occurred predominantly within the first 6 weeks after injury. From baseline to 6 weeks, patients with baseline AIS B and C exhibited significantly greater improvement in total motor score than those with AIS A and D. From 6 weeks to 6 months, measurable recovery persisted in patients with AIS C at 6 weeks, whereas those with AIS A or B demonstrated minimal additional gains. AIS conversion followed a similar pattern: 38.5%, 63.6%, and 82.7% among patients with baseline AIS A, B, and C, respectively, which improved by 6 weeks, whereas conversions beyond 6 weeks were uncommon. Among patients who remained AIS A or B at 6 months, motor zone of partial preservation extension occurred almost exclusively within the first 6 weeks.
In older patients with cervical spinal cord injury, most neurological recovery under routine clinical practice occurs within the first 6 weeks after injury. The magnitude of motor recovery and AIS conversion in this cohort was comparable to outcomes reported in age-unrestricted populations, suggesting that meaningful early neurological recovery can be observed even in older patients and highlighting the importance of early neurological assessment.

PMID:
42893313
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.