Article

The International Standards for
Neurological Classification of Spinal Cord Injury (ISNCSCI) assesses cutaneous
sensibility through light touch (LT) and sharp-dull discrimination, referred to
as pin prick (PP). This project aimed to confirm a tendency for LT to score
higher than PP in SCI subjects and discuss possible reasons for such disparity.
SETTING: Single site cohort study, the London Spinal Cord Injury Centre, United
Kingdom. METHODS: A retrospective analysis of LT and PP scores of 99 spinal cord
injury subjects at the time of discharge (median 5 months) from acute care and
rehabilitation in the London Spinal Cord Injury Centre was conducted. Subjects
were aged 10-88 years (median 44 years; 78 men, 74 traumatic, 25 non-traumatic).
There were 40 American Spinal Injury Association (ASIA) Impairment Scale (AIS) A,
7 B, 18 C and 34 D subjects. RESULTS: A disparity (P<0.001) was found between LT
(64.5+/-3.2, mean+/-s.e.) and PP (54.7+/-2.9) AIS sensory scores. A similar
difference in score (LT>PP) was registered both for traumatic and non-traumatic
injury, but was greater for incomplete than for complete injury. Despite the
difference, LT was well correlated with PP (R=0.87, P<0.001). Spinal segmental
level of injury was determined more frequently by PP alone (43 of 99) than by LT
(10 of 99) alone. CONCLUSION: The discrepancies between LT and PP could relate to
the greater complexity of the PP test or a difference in the extent of injury to
the posterior columns (LT) and spinothalamic (PP) tracts. Further interpretation
would benefit from additional electrophysiological sensory tests.

Langue : ANGLAIS