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

Abstract

STUDY DESIGN: Retrospective cohort study of prospectively registered and collected data. OBJECTIVE(S): To compare the outcomes of people with a traumatic spinal cord injury (SCI) or cauda equina injury (CEI). SETTING: Victorian State Trauma System, Australia. METHOD(S): 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 details were extracted. Follow-up was conducted by the registry up to 24-months post injury, including the World Health Organization Disability Assessment Schedule (WHODAS), EuroQol EQ-5D scale, and return to work. RESULT(S): Of the 1156 participants, 1113 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(S): 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.Copyright © 2026. The Author(s).