COaT-SCI – the Study
Clinical guidelines and treatment strategies for paraplegia are currently based on a very limited body of evidence. Due to the low incidence and the marked heterogeneity of spinal cord injuries, randomized clinical studies cannot be performed in large numbers. Furthermore, despite intensive research no treatment has been established yet to facilitate neuronal regeneration after paraplegia. The numerous sequelae and complications of paraplegia demand causal or symptomatic therapy. Decisions about individual therapies are rendered complex by the changing epidemiology of the disease, specifically the increasing age of patients with CNS injuries (Roozenbeek et al. 2013, Nat Rev Neurol. 9:231-6). Besides, factors such as specific previous diseases, accompanying injuries (as detailed by Gabbe et al. 2005, Acad Emerg Med.12:318-21), and specific complications of paraplegia (Kopp et al., 2017, Neurology 88:892-900; Failli et al., 2012, Brain 135:3238–50) are believed to impair the clinical success of treatment concepts and also limit the conduct of clinical trials to a significant extent.
The primary aim of this register is to conduct a long-term clinical investigation of patients with paraplegia due to traumatic, inflammatory, tumor-related or other causes while taking the multimodality treatment concept used for the respective patient and the channels of patient management into account. Further aims of the study are to present the clinical and sociomedical course of paraplegia (reintegration, patient satisfaction), and identify potential factors that influence the patients’ functional recovery and quality of life. Treatment concepts in clinical practice will be compared in terms of their risk-benefit ratio. Furthermore, the treatments in use and the existing care structures will be analyzed in terms of their costs and effectiveness.