Joint Position Sense Evaluation in Spinal Cord Injury

Main Article Content

Nath Adulkasem
Wallop Adulkasem

Abstract

The ASIA Impairment Scale (AIS) is considered the gold standard for evaluating spinal cord injuries. This scoring system is based on remaining motor and sensory function. Fine touch is representative of the dorsal column-medial lemniscus pathway, which also provides proprioceptive sensation, two-point discrimination and vibration sensation. This report suggests that the assessment of multiple sensory modalities could improve the reliability and validity of the AIS scoring system. We report on a traumatic spinal cord injury patient classified as AIS grade A but who had retained joint position sensation. Computed tomography revealed a fracture dislocation of the C6 and C7 vertebra with 100% canal compromise. He subsequently underwent posterior open reduction and instrumentation with posterior fusion at the C6 and C7 level. At the five year follow-up, he presented with significant neurological improvement

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How to Cite
1.
Adulkasem N, Adulkasem W. Joint Position Sense Evaluation in Spinal Cord Injury. BKK Med J [Internet]. 2020 Feb. 25 [cited 2024 Nov. 22];16(1):84. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/239985
Section
Case Report

References

Hales M, Biros E, Reznik JE. Reliability and validity of the sensory component of the international standards for neurological classification of spinal cord injury (ISNCSCI): A systematic review. Top Spinal Cord Inj Rehabil 2015;21(3):241-9.

Hayes KC, Wolfe DL, Hsieh JT, et al. Clinical and electrophysiologic correlates of quantitative sensory testing in patients with incomplete spinal cord injury. Arch Phys Med Rehabil 2002;83(11):1612-9.

Mulcahey MJ, Gaughan J, Betz RR, et al. Rater agreement on the ISCSCI motor and sensory scores obtained before and after formal training in testing technique. J Spinal Cord Med 2007;30 (Suppl 1):S146-9.

Vissarionov S, Baindurashvili A, Kryukova I. International standards for neurological classification of spinal cord injuries (ASIA/ISNCSCI scale, revised 2015) 67. Ped Traumatol Ortho Recon Surg 2016;4:67.

van Middendorp JJ, Goss B, Urquhart S, et al. Diagnosis and prognosis of traumatic spinal cord injury. Global Spine J 2011;1(1):1-8.

Tibbetts PE. The Quarterly review of biology. Principles of Neural Science, Fifth edited 2013;88(2):139-40.

Walsh LD, Moseley GL, Taylor JL, et al. Proprioceptive signals contribute to the sense of body ownership. J Physiol 2011;589(Pt 12):3009-21.

Defrin R, Ohry A, Blumen N, et al. Characterization of chronic pain and somatosensory function in spinal cord injury subjects. Pain 2001;89(2-3):253-63.

Stillman BC. Making sense of proprioception: The meaning of proprioception, kinaesthesia and related terms. Physiotherapy 2002;88(11):667-76.

Al-Chalabi M AI. Neuroanatomy, Posterior Column (Dorsal Column). Treasure Island (FL): StatPearls Publishing. 2019.

Lodhi MU, Kuzel AR, Syed IA, et al. An atypical clinical presentation of post-traumatic syringomyelia: a case report and brief review of the literature. Cureus 2017;9(11):e1852-e.

Ditunno JF Jr, Young W, Donovan WH, et al. The international standards booklet for neurological and functional classification of spinal cord injury. American Spinal Injury Association. Paraplegia 1994;32(2):70-80.

van Middendorp JJ, Hosman AJ, Doi SA. The effects of the timing of spinal surgery after traumatic spinal cord injury: a systematic review and meta-analysis. J Neurotrauma. 2013;30(21):1781-94.

Ter Wengel PV, Feller RE, Stadhouder A, et al. Timing of surgery in traumatic spinal cord injury: a national, multidis- ciplinary survey. Eur Spine J 2018;27(8):1831-8.