Prognostic value of pinprick preservation in motor complete, sensory incomplete spinal cord injury

Objective: To assess sacral and lower-extremity pinprick preservation as prognostic indicators for ambulation in motor complete, sensory incomplete spinal cord injury (SCI). Design: Retrospective analysis. Setting: Twenty-eight tertiary care centers in the United States and Canada. Participants: Subjects (N= 131; mean age, 31.6y) with motor complete, sensory incomplete SCI. Interventions: Not applicable. Main Outcome Measure: Ambulation at 26 and 52 weeks postinjury (modified Benzel scale). Results: A higher percentage of subjects with sacral pinprick preservation at baseline were ambulating at 26 (39.4% vs 28.3%) and 52 weeks (53.6% vs 41.5%). This finding did not reach statistical significance. The presence of sacral pinprick preservation at 4 weeks postinjury was significant for predicting ambulation at 52 weeks postinjury (36.0% vs 4.4%, P=.011) and approached significance at 26 weeks (15.2% vs 0.0%, P=.056). Significant differences in ambulation rates were also observed between subjects, based on the presence of baseline lower-extremity pinprick preservation ( >= 50% of lower-extremity L2-S1 dermatomes) at both 26 (50.0% vs 28.8%, P=.048) and 52 weeks (66.7% vs 40.3%, P=.023) after injury. Conclusions: Baseline lower-extremity pinprick preservation and sacral pinprick preservation at 4 weeks postinjury are associated with an improved prognosis for ambulation. (c) 2005 by American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.