Dr. Neil Riordan on health: what the evidence says · JRE #1066
SUBJECT: HEALTH
The short answer
Riordan states that neurosurgeons designing his Miami spinal cord injury trial hold that patients recover 98-99% of their natural neurologic function by six months post-injury. The natural history literature on spinal cord injury (SCI) recovery, most notably the International Campaign for Cures of Spinal Cord Injury Paralysis (ICCP) panel's 2007 analysis, describes spontaneous recovery as highly heterogeneous rather than following one fixed percentage: recovery in motor-complete injuries (AIS A/B) is limited and largely confined to the zone of partial preservation, while recovery in motor-incomplete injuries (AIS C/D) is substantially larger and more variable.
Not a true/false call. Every claim is logged with its sources; read the exhibits below.
there are two neurosurgeons that are on that. So we wanted to, okay, we're discussing at what time point should we accept them? And these very prominent neurosurgeons said, let's do six months, because at six months, you got 98 to 99% back of everything you're going to have.
What the evidence says 01 / RECORD
Riordan stated that neurosurgeons involved in designing his spinal cord injury trial hold that patients recover 98-99% of their eventual neurologic function within six months of injury, using this as the basis for a six-month endpoint. The natural history literature on spinal cord injury (SCI) recovery, most notably the International Campaign for Cures of Spinal Cord Injury Paralysis (ICCP) panel's 2007 analysis, describes spontaneous recovery as highly heterogeneous rather than following one fixed percentage: recovery in motor-complete injuries (AIS A/B) is limited and largely confined to the zone of partial preservation, while recovery in motor-incomplete injuries (AIS C/D) is substantially larger and more variable. The same analysis found the majority of spontaneous recovery occurs within the first three months post-injury, with a smaller amount continuing for up to 18 months or longer, which is broadly consistent with recovery slowing markedly by six months but does not support a uniform "98 to 99%" figure applicable to all patients regardless of injury completeness or level. Because outcomes differ so much by baseline AIS grade, injury level, and cause, a single blanket recovery percentage at a fixed time point is an oversimplification of the underlying evidence, even though the general direction (recovery plateaus within roughly six months to a year) is broadly supported. Status: misleading/oversimplified rather than fabricated.