Identification of a reliable sacral-sparing examination to assess the ASIA impairment scale in patients with traumatic spinal cord injury.
J Spinal Cord Med
; : 1-7, 2022 Mar 30.
Article
em En
| MEDLINE
| ID: mdl-35352975
ABSTRACT
OBJECTIVES:
We evaluated the time course of the American Spinal Cord Injury Association (ASIA) impairment scale (AIS) for up to three months in participants within 72â h after traumatic spinal cord injury (TSCI) with complete paralysis. We aimed to determine the most useful sacral-sparing examination (deep anal pressure [DAP], voluntary anal contraction [VAC], S4-5 light touch [LT], or pin prick [PP] sensation) in determining AIS grades.DESIGN:
Retrospective cohort study.SETTING:
Spinal Injuries Center, Fukuoka, Japan.PARTICIPANTS:
Among 668 TSCI participants registered in the Japan Single Center study for Spinal Cord Injury Database (JSSCI-DB) between January 2012 and May 2020, we extracted the data of 80 patients with AIS grade A within 72â h after injury and neurological level of injury (NLI) at T12 or higher.INTERVENTIONS:
None. OUTCOMEMEASURES:
The sacral-sparing examination at the time of the change to incomplete paralysis was compared to the AIS determination using a standard algorithm and with each assessment including the VAC, DAP, S4-5LT, and S4-5PP examinations at the time of AIS functional change. Agreement among assessments was evaluated using weighted kappa coefficients. The relationship was evaluated using Spearman's rank correlation coefficients.RESULTS:
Fifteen participants (18.8%) improved to incomplete paralysis (AIS B to D) within three months after injury. The single assessment among the sacral-sparing examinations with the highest agreement and strongest correlation with AIS determination was the S4-5LT examination (k = 0.89, P < 0.01, r = 0.84, P < 0.01).CONCLUSIONS:
The S4-5LT examination is key in determining complete or incomplete paralysis due to its high discriminatory power.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Spinal Cord Med
Ano de publicação:
2022
Tipo de documento:
Article