Betz Randal R, Chafetz Ross S, Vogel Lawrence C, Samdani Amer F, Mulcahey Mary Jane
Shriners Hospitals for Children, PA, USA.
J Spinal Cord Med. 2011;34(3):297-300. doi: 10.1179/2045772311Y.0000000009.
BACKGROUND/OBJECTIVE: This cross-sectional, multicenter cohort study describes patterns of preserved sensation in persons with American Spinal Injury Association (ASIA) Impairment Scale (AIS) B (sensory incomplete, or SI) and AIS C/D (motor incomplete, or MI).
A total of 93 subjects with incomplete spinal injuries (58 with tetraplegia and 35 with paraplegia) were included for analysis. Sensation was based on the International Standards for Neurological Classification of SCI (ISNCSCI).
In the 44 subjects with AIS B (SI), some light touch (LT) was present in 35% of dermatomes below the neurological level and pin prick (PP) in 8%. In contrast, in the 49 subjects with AIS C/D (MI), LT was present in 77% of dermatomes and PP in 27%. AIS C/D (MI) subjects with tetraplegia had more dermatomes with preserved sensation than those with paraplegia. When reviewing areas at highest risk for pressure sores, only 4 of 22 (19%) of subjects with AIS B (SI)/tetraplegia had any preserved LT or PP sensation in the periscapular region (dermatomes T1-T6). In the buttocks region (S3 and S4-S5), sensation was preserved in fewer than 50% of patients with either tetraplegia or paraplegia.
(1) Sensory sparing below the neurologic injury was found to be surprisingly sparse in patients classified as AIS B (SI) (35% LT and 8% PP). Sparing was considerably better in patients who were AIS C/D (MI) (77% LT and 27% PP). (2) Preserved sensation in the periscapular region was very low in subjects with tetraplegia (19%) and was also low in the buttocks, with fewer than half of those classified as AIS B (SI) with either tetraplegia or paraplegia reporting sensation.
背景/目的：这项横断面多中心队列研究描述了美国脊髓损伤协会（ASIA）损伤量表（AIS）B级（感觉不完全损伤，或SI）和AIS C/D级（运动不完全损伤，或MI）患者的感觉保留模式。
共纳入93例不完全性脊髓损伤患者（58例四肢瘫和35例截瘫）进行分析。感觉评估基于脊髓损伤神经学分类国际标准（ISNCSCI）。
在44例AIS B级（SI）患者中，神经平面以下35%的皮节存在一些轻触觉（LT），8%存在针刺觉（PP）。相比之下，在49例AIS C/D级（MI）患者中，77%的皮节存在LT，27%存在PP。四肢瘫的AIS C/D级（MI）患者比截瘫患者有更多感觉保留的皮节。在评估压疮高危区域时，22例AIS B级（SI）/四肢瘫患者中只有4例（19%）在肩胛周围区域（皮节T1 - T6）有任何保留的LT或PP感觉。在臀部区域（S3和S4 - S5），四肢瘫或截瘫患者中感觉保留的不到50%。
（1）在分类为AIS B级（SI）的患者中，神经损伤平面以下的感觉保留令人惊讶地稀少（35%的LT和8%的PP）。在AIS C/D级（MI）患者中保留情况要好得多（77%的LT和27%的PP）。（2）四肢瘫患者肩胛周围区域的感觉保留非常低（19%），臀部区域也很低，AIS B级（SI）的四肢瘫或截瘫患者中报告有感觉的不到一半。
