Identification of a reliable sacral-sparing examination to assess the ASIA impairment scale in patients with traumatic spinal cord injury

Autor: Yuto Ariji, Tetsuo Hayashi, Ryosuke Ideta, Ryuichiro Koga, Satoshi Murai, Tomoki Naka, Ryusei Ifuku, Fumihiro Towatari, Hiroaki Sakai, Hiroyuki Kurata, Takeshi Maeda
Rok vydání: 2022
Předmět:
Zdroj: The Journal of Spinal Cord Medicine. :1-7
ISSN: 2045-7723
1079-0268
DOI: 10.1080/10790268.2022.2047548
Popis: We evaluated the time course of the American Spinal Cord Injury Association (ASIA) impairment scale (AIS) for up to three months in participants within 72 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.Retrospective cohort study.Spinal Injuries Center, Fukuoka, Japan.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 72 h after injury and neurological level of injury (NLI) at T12 or higher.None.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.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 (The S4-5LT examination is key in determining complete or incomplete paralysis due to its high discriminatory power.
Databáze: OpenAIRE
Externí odkaz: