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Prognostic Value of Pinprick Preservation in Motor Complete, Sensory Incomplete Spinal Cord Injury

      Abstract

      Oleson CV, Burns AS, Ditunno JF, Geisler FH, Coleman WP. Prognostic value of pinprick preservation in motor complete, sensory incomplete spinal cord injury.

      Objective

      To assess sacral and lower-extremity pinprick preservation as prognostic indicators for ambulation in motor complete, sensory incomplete spinal cord injury (SCI).

      Design

      Retrospective analysis.

      Setting

      Twenty-eight tertiary care centers in the United States and Canada.

      Participants

      Subjects (N=131; mean age, 31.6y) with motor complete, sensory incomplete SCI.

      Interventions

      Not applicable.

      Main outcome measure

      Ambulation at 26 and 52 weeks postinjury (modified Benzel scale).

      Results

      A higher percentage of subjects with sacral pinprick preservation at baseline were ambulating at 26 (39.4% vs 28.3%) and 52 weeks (53.6% vs 41.5%). This finding did not reach statistical significance. The presence of sacral pinprick preservation at 4 weeks postinjury was significant for predicting ambulation at 52 weeks postinjury (36.0% vs 4.4%, P=.011) and approached significance at 26 weeks (15.2% vs 0.0%, P=.056). Significant differences in ambulation rates were also observed between subjects, based on the presence of baseline lower-extremity pinprick preservation (≥50% of lower-extremity L2-S1 dermatomes) at both 26 (50.0% vs 28.8%, P=.048) and 52 weeks (66.7% vs 40.3%, P=.023) after injury.

      Conclusions

      Baseline lower-extremity pinprick preservation and sacral pinprick preservation at 4 weeks postinjury are associated with an improved prognosis for ambulation.

      Key words

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