Model System:

SCI

Reference Type:

Journal

Accession No.:

J74691

Journal:



Year, Volume, Issue, Page(s):

, 97, 10, 1642-1646

Publication Website:

Abstract:

Study investigated whether pressure sensation at the S3 dermatome (a new test) could be used in place of deep anal pressure (DAP) to determine completeness of injury as part of the neurological classification of spinal cord injury (SCI). This prospective, multicenter observational study was conducted as a collaborative module among 5 SCI Model Systems centers. A total of 125 participants with acute traumatic SCI, neurologic levels T12 and above, were examined at 1 month (baseline), 3, 6, and 12 months postinjury. Pressure sensation over the ischial tuberosities (S3) was tested at each time point and was repeated within 3 days of the 1-month examination. Test-retest reliability and agreement (k), sensitivity, specificity, and positive and negative predictive values were calculated. Test-retest reliability of S3 pressure at 1 month was almost perfect (k=.98). Agreement of S3 pressure with DAP was substantial both at 1 month (k=.73) and for all time points combined (k=.76). The positive predictive value of S3 pressure for DAP was 89.3 percent at baseline and 90.3 percent for all time points. No pattern in outcomes was seen in those cases where S3 pressure and DAP differed at 1 month. Based on the findings, the authors recommend S3 pressure as an alternative test of sensory sacral sparing for supraconus SCI, at least in cases where DAP cannot be tested. Further research is needed to determine whether S3 pressure could replace DAP for classification of SCI.

Author(s):