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

This study aimed to find the most effective sacral-sparing examination to determine the severity of spinal cord injuries using the ASIA Impairment Scale (AIS). Sacral-sparing examinations include tests like deep anal pressure (DAP), voluntary anal contraction (VAC), and light touch (LT) and pin prick (PP) sensation in the S4-5 region. The study found that the S4-5 light touch sensation test was the most reliable for determining whether a patient had complete or incomplete paralysis. This means it could help doctors quickly and accurately assess the extent of spinal cord injury. Using the S4-5 light touch test alone can provide similar results to using the full standard assessment, potentially simplifying the evaluation process for patients with traumatic spinal cord injuries.

• 1
  The S4-5LT examination demonstrated the highest agreement and strongest correlation with AIS determination (k = 0.89, P < 0.01, r = 0.84, P < 0.01).
• 2
  18.8% of participants with an AIS grade of A at 72 hours post-injury improved to incomplete paralysis (AIS grades B–D) by three months post-injury.
• 3
  80% of individuals with improvement to incomplete paralysis recovered within four weeks after injury, with improvements in S4-5LT and DAP evaluations.