Secondary conditions in a community sample of people with spinal cord damage

Objective: To compare secondary conditions in people with traumatic spinal cord injury (SCI) and non-traumatic spinal cord dysfunction (SCDys). Design: Survey; completed August 2012-June 2013. Setting: Community, Australia. Participants: Adults with spinal cord damage from any cause. Interventions: Nil. Outcome Measures: Demographic and clinical variables and the SCI-Secondary Conditions Scale (SCI-SCS). Results: Survey completed by 150 people: 112 (74.7%) with traumatic SCI and 38 (25.3%) with non-traumatic SCDys a median of 10 years post onset. No significant difference (t =-0.6, P = 0.6) in the total SCI-SCS score between those with SCI (mean 13.7) and SCDys (mean 14.4). Except for bladder problems (SCDys mean = 1.5, SD = 1.1; SCI mean = 1.0, SD= 1.1; t =-2.6, P = 0.01) there were no significant differences between the aetiology groups regarding the conditions comprising the SCI-SCS (all other P values > 0.1). The most common significant or chronic problems from the SCI-SCS were: sexual problems 41%; chronic pain 24%; bladder dysfunction 17%; spasms 17%; joint and muscle pain 15%; bowel dysfunction 14%; circulation problems 14%; contractures 9%; urinary tract infections 9%; pressure ulcer 7% and postural hypotension 5%. A linear regression analysis found that tetraplegia and higher disability were the only variables that significantly influenced (R-2 = 0.13; P = 0.005) the total SCI-SCS score and that sex, age, years post injury and etiology of spinal cord damage had no influence. Conclusions: Secondary conditions following spinal cord damage do not appear to be influenced by etiology. Prevention and management of secondary conditions following need to consider people with non-traumatic SCDys as well as those with traumatic SCI.