Spinal cord injury: prognosis for ambulation based on sensory examination in patients who are initially motor complete

Abstract

The purpose of this retrospective study was to document that patients with motor complete injury, but preserved pin appreciation, in addition to light touch, below the zone of injury have better prognoses with regard to ambulation than patients with only light touch preserved. Medical records were examined of all spinal cord injury (SCI) patients admitted between 1982 and 1988. Twenty-seven Frankel B patients with upper motor neuron lesions admitted within 72 hours of injury were identified. These patients were divided into two groups (B-1 and B-2). Group B-1 (n = 18) were patients who had touch sensation but no pin appreciation below the zone of injury. Group B-2 (n = 9) were patients who had partial or complete pin appreciation and light touch below the zone of injury. The charts were examined for the patient's ability to walk independently using a reciprocal gait for at least 200 feet. The data were analyzed by the Fisher Exact test. Eight of the nine Group B-2 patients ambulated as compared to two of the 18 Group B-1 patients (p less than .0002). Frankel B SCI patients with only touch preserved below the zone of injury had poor prognoses for ambulation; those with preserved pin appreciation below the zone of injury had excellent prognoses to regain functional ambulation.