Observation on Posterior Column Sensations as Predictor of Neurological Recovery in Spinal Cord Injury Patients

Abstract

Objective: This study evaluated the role of preservation of posterior column in final prognosis of SCI and also compared prognostic values of posterior column and spino-thalamic tract sparing in SCI. Methodology: A prospective observational study was conducted in Department of Physical medicine and Rehabilitation in SVNIRTAR, Odisha, India from July 2017 to Dec 2018. Sample size was 55 and incomplete spinal cord injuries in ASIA B-E, neurological level C5 and below, age >10 yrs were included. Patients were classified into 2 groups of posterior column sparing and spino-thalamic sensory sparing. Patients were evaluated using ASIA scale, Neurological examination by ISNCSCI and functional improvement by SCIM III.2 groups were reassessed after 6, 9, 12 months. Results: Pure posterior column sensory sparing patients were 6 out of 55 and 50% belonged to C6 vertebral level. All 6 remained in ASIA B after 1 yr while 9 of ASIA B converted to C,10 from ASIA C to D and 1 from ASIA D to E. There were significant changes in motor and sensory scores of 2 groups which were statistically significant. SCIM score in Group A increased by 9.7 points after 1yr while there was 31.1 increase in Group B. Conclusion: Pure posterior column sensory sparing in spinal cord injury is poor prognostic indicator for neurological recovery when compared to spino-thalamic sparing patients.