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Effects of Pain and Pain Management on Motor Recovery of Spinal Cord-Injured Patients

Approximately 60% of patients suffering from acute spinal cord injury
(SCI) develop pain within days to weeks after injury, which ultimately persists
into chronic stages. To date, the consequences of pain after SCI have been
largely examined in terms of interfering with quality of life.
The objective of this study was to examine the effects of pain and pain management on
neurological recovery after SCI. Methods We analyzed clinical data in a
prospective multicenter observational cohort study in patients with SCI. Using
mixed effects regression techniques, total motor and sensory scores were modelled
at 1, 3, 6, and 12 months postinjury. Results A total of 225 individuals were
included in the study (mean age: 45.8 +/- 18 years, 80% male). At 1 month
postinjury, 28% of individuals with SCI reported at- or below-level neuropathic
pain. While pain classification showed no effect on neurological outcomes,
individuals administered anticonvulsant medications at 1 month postinjury showed
significant reductions in pain intensity (2 points over 1 year; P < .05) and
greater recovery in total motor scores (7.3 points over 1 year; P < .05). This
drug effect on motor recovery remained significant after adjustment for injury
level and injury severity, pain classification, and pain intensity. Conclusion
While initial pain classification and intensity did not reveal an effect on motor
recovery following acute SCI, anticonvulsants conferred a significant beneficial
effect on motor outcomes. Early intervention with anticonvulsants may have
effects beyond pain management and warrant further studies to evaluate the
therapeutic effectiveness in human SCI.
CI - (c) The Author(s) 2016.

Langue : ANGLAIS

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