Curt A, Dietz V
Swiss Paraplegic Centre, University Hospital Balgrist, Zürich, Switzerland.
Arch Phys Med Rehabil. 1997 Jan;78(1):39-43. doi: 10.1016/s0003-9993(97)90007-1.
Prediction of outcome of ambulatory capacity in patients with acute spinal cord injury (SCI) by the American Spinal Injury Association (ASIA) protocol and somatosensory evoked potentials (SSEP).
Correlational study on a prospective cohort.
Spinal cord injury center, university hospital.
Consecutively sampled, 70 acute and 34 chronic SCI patients.
(1) ASIA motor and sensory scores; (2) tibial and pudendal SSEP graded in 5 categories, from normal to absent; (3) ambulatory capacity rated as no, therapeutic, functional, or full. The outcome of the ambulatory capacity was assessed after discharge from the rehabilitation program, at least 6 months after trauma.
In acute SCI both the initial ASIA scores and the SSEP recordings are related (p < .001) to the outcome of ambulatory capacity. In acute tetraplegia the pudendal SSEP (spearman corr. coeff. .92; p < .001) and in acute paraplegia the ASIA motor score (spearman corr. coeff. .90; p < .001) were best related to the outcome of ambulatory capacity. In the early stage of acute SCI, ASIA scores and SSEP recordings can help to assess the outcome of ambulatory capacity and, therefore, can contribute to the selection of the appropriate therapeutic approaches during the rehabilitation program. In patients with acute SCI the ASIA motor score significantly increased (p < .05) in the 6 months after trauma, whereas the ASIA sensory scores and SSEP recordings did not change significantly during this same period.
ASIA scores and SSEP are related to the outcome of ambulatory capacity in patients with acute spinal cord injury; in noncomprehensive or uncooperative patients the SSEP are of supplemental value to the clinical examination. Therefore, the combination of clinical and electrophysiological examinations can be of additional diagnostic value in the assessment of acute spinal cord injury.
通过美国脊髓损伤协会（ASIA）标准和体感诱发电位（SSEP）预测急性脊髓损伤（SCI）患者的步行能力结局。
前瞻性队列相关性研究。
大学医院脊髓损伤中心。
连续抽样的70例急性和34例慢性SCI患者。
（1）ASIA运动和感觉评分；（2）胫神经和阴部神经SSEP分为5类，从正常到消失；（3）步行能力分为无、治疗性、功能性或完全性。步行能力结局在康复计划出院后、创伤后至少6个月进行评估。
在急性SCI中，初始ASIA评分和SSEP记录均与步行能力结局相关（p <.001）。在急性四肢瘫中，阴部神经SSEP（斯皮尔曼相关系数.92；p <.001），在急性截瘫中，ASIA运动评分（斯皮尔曼相关系数.90；p <.001）与步行能力结局相关性最佳。在急性SCI早期，ASIA评分和SSEP记录有助于评估步行能力结局，因此有助于在康复计划期间选择合适的治疗方法。急性SCI患者在创伤后6个月内ASIA运动评分显著增加（p <.05），而在此期间ASIA感觉评分和SSEP记录无显著变化。
ASIA评分和SSEP与急性脊髓损伤患者的步行能力结局相关；在不全面或不合作的患者中，SSEP对临床检查具有补充价值。因此，临床和电生理检查相结合在评估急性脊髓损伤中可能具有额外的诊断价值。
