Roop Singh 1 , Jitendra Wadhwani 1 , Vijay Singh Meena 1 , Pankaj Sharma 1 , Kiranpreet Kaur 2 Show Affiliations »
Abstract
BACKGROUND: To investigate the relationship between neurological deficit and subsequent recovery as assessed by ASIA score and findings of electrodiagnostic study in acute spinal cord injury (SCI) patients. METHODS: Thirty-five patients with acute SCI presenting within 48 h of injury were clinically evaluated for the level, extent, and severity of SCI according to the ASIA standards in a tertiary-level care center. Electrodiagnostic studies of bilateral two motor (tibial and peroneal), one sensory (sural) nerves, and five muscles [iliopsoas, vastus medialis, tibialis anterior, gastrocnemius, and extensor hallucis longus (EHL)] were conducted and repeated at 3 months and 6 months. RESULTS: The neurological recovery was highly significant (p < 0.001) at 6 months. The difference in mean amplitude was statistically significant (p < 0.05) for all the nerves; mean conduction velocity significant for peroneal and sural nerves, and with no significant difference in mean latency. The differences in mean recruitment of motor unit potential (MUP) and mean peak-to-peak amplitude were highly significant (p < 0.001). Statistically significant kappa agreement between neurological recovery according to ASIA score and nerve conduction velocity was found for right tibial nerve (K = 0.324); electromyography finding of recruitment of MUP with right and left tibialis anterior (k = 0.400) and left EHL (k = 0.407); peak-to-peak amplitude with right tibialis anterior (k = 0.211), right gastrocnemius (k = 0.390), and right EHL (k = 0.211). CONCLUSIONS: There is a strong relationship between electrodiagnostic findings and ASIA scoring to predict neurological deficit and subsequent recovery after acute traumatic SCI. Serial neurologic evaluation by ASIA score and electrodiagnostic studies may help in designing customized rehabilitation programs for the patients according to the expected neurological recovery; and evaluating future research in the field of SCI with more scientific authenticity. © Indian Orthopaedics Association 2020.
BACKGROUND: To investigate the relationship between neurological deficit and subsequent recovery as assessed by ASIA score and findings of electrodiagnostic study in acute spinal cord injury (SCI) patients. METHODS: Thirty-five patients with acute SCI presenting within 48 h of injury were clinically evaluated for the level, extent, and severity of SCI according to the ASIA standards in a tertiary-level care center. Electrodiagnostic studies of bilateral two motor (tibial and peroneal), one sensory (sural) nerves, and five muscles [iliopsoas, vastus medialis, tibialis anterior, gastrocnemius, and extensor hallucis longus (EHL)] were conducted and repeated at 3 months and 6 months. RESULTS: The neurological recovery was highly significant (p < 0.001) at 6 months. The difference in mean amplitude was statistically significant (p < 0.05) for all the nerves; mean conduction velocity significant for peroneal and sural nerves, and with no significant difference in mean latency. The differences in mean recruitment of motor unit potential (MUP) and mean peak-to-peak amplitude were highly significant (p < 0.001). Statistically significant kappa agreement between neurological recovery according to ASIA score and nerve conduction velocity was found for right tibial nerve (K = 0.324); electromyography finding of recruitment of MUP with right and left tibialis anterior (k = 0.400) and left EHL (k = 0.407); peak-to-peak amplitude with right tibialis anterior (k = 0.211), right gastrocnemius (k = 0.390), and right EHL (k = 0.211). CONCLUSIONS: There is a strong relationship between electrodiagnostic findings and ASIA scoring to predict neurological deficit and subsequent recovery after acute traumatic SCI. Serial neurologic evaluation by ASIA score and electrodiagnostic studies may help in designing customized rehabilitation programs for the patients according to the expected neurological recovery; and evaluating future research in the field of SCI with more scientific authenticity. © Indian Orthopaedics Association 2020.
Entities: Chemical
Keywords:
ASIA score; Electromyography; Nerve conduction; Spinal cord injury; magnetic resonance imaging
Year: 2020
PMID： 32850033 PMCID： PMC7429802 DOI： 10.1007/s43465-020-00108-4
Source DB: PubMed Journal: Indian J Orthop ISSN： 0019-5413 Impact factor: 1.251