A Comparison of Diagnostic Stability of the ASIA Impairment Scale Versus Frankel Classification Systems for Traumatic Spinal Cord Injury

Archives of Physical Medicine and Rehabilitation
Steven KirshblumNicole Wagaman

Abstract

To determine whether the "sacral sparing" definition for completeness of traumatic spinal cord injury (SCI) is a more stable definition than the previously used Frankel Classification. Retrospective analysis of individuals enrolled in the Spinal Cord Injury Model Systems (SCIMS) database between 2011 and 2018. SCIMS centers. Individuals (N=804) with traumatic SCI who were at least 16 years old at time of injury, were admitted to rehabilitation within 30 days, had American Spinal Injury Association Impairment Scale (AIS) grades A-D at admission, and had complete neurologic data at the time of admission and 1 year. Not applicable. Frankel and AIS scores were computed for a cohort of 804 eligible cases. Stability was compared between the 2 classification systems by calculating the proportions of cases in which regression (conversion to a more severe impairment level) was observed. A larger proportion of individuals classified with "incomplete" injuries (grades B-D) at the time of admission using the Frankel system regressed to complete status at 1 year compared with the AIS criteria (9.4% vs 2.0%). Those with grade B injuries regressed to grade A more often using the Frankel system compared with the AIS system (19.7% to 5.4%). A l...Continue Reading

Citations

Dec 20, 2020·Journal of Neurotrauma·Steven KirshblumJames Guest
Nov 21, 2021·Archives of Physical Medicine and Rehabilitation·Steven KirshblumRalph Marino

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