Waters R L, Adkins R H, Yakura J S
Clinical Professor of Orthopedic Surgery, University of Southern California.
Paraplegia. 1991 Nov;29(9):573-81. doi: 10.1038/sc.1991.85.
Prospective serial neurological examinations were performed on 445 consecutive traumatic spinal cord injury (SCI) patients admitted for rehabilitation on an average of 22.8 +/- 15.6 days after injury. Patients were categorized by both the ASIA and Sacral Sparing (SS) definitions of complete SCI, in order to compare the definitions in terms of consistency and prognostic ability. Recovery during follow-up was determined by sensory scores for light touch, sharp/dull discrimination, proprioception, and the ASIA Motor Index Score. Change in complete status was unidirectional using the SS definition and bidirectional using the ASIA definition. Twelve patients with SS complete injuries on initial examination converted to SS incomplete injuries at follow-up. No patients converted from SS incomplete to SS complete injury. Twenty three patients with ASIA complete injuries upon admission converted to ASIA incomplete status and 6 converted from ASIA incomplete status on admission to ASIA complete status at follow-up. For quadriplegics, the average motor recovery for patients changing complete status according to the ASIA definition was 11.7 +/- 10.3, which was significantly less (p less than .05) than the average recovery using the SS definition (group 1), 17.9 +/- 9.3. For paraplegics, the average motor recovery using the ASIA definition, 8.3 +/- 6.7, did not differ significantly from the value using the SS definition, 6.8 +/- 4.0.
对445例因康复入院的连续创伤性脊髓损伤（SCI）患者进行了前瞻性系列神经学检查，这些患者受伤后平均22.8±15.6天入院。根据ASIA和骶部保留（SS）对完全性SCI的定义对患者进行分类，以便比较这两种定义在一致性和预后能力方面的差异。随访期间的恢复情况通过轻触觉、锐/钝辨别、本体感觉的感觉评分以及ASIA运动指数评分来确定。使用SS定义时，完全性状态的变化是单向的，而使用ASIA定义时是双向的。12例初始检查时为SS完全性损伤的患者在随访时转变为SS不完全性损伤。没有患者从SS不完全性损伤转变为SS完全性损伤。23例入院时为ASIA完全性损伤的患者转变为ASIA不完全性状态，6例入院时为ASIA不完全性状态的患者在随访时转变为ASIA完全性状态。对于四肢瘫痪患者，根据ASIA定义改变完全性状态的患者平均运动恢复为11.7±10.3，明显低于（p<0.05）使用SS定义（第1组）的平均恢复值17.9±9.3。对于截瘫患者，使用ASIA定义的平均运动恢复值8.3±6.7与使用SS定义的值6.8±4.0没有显著差异。
