OBJECTIVE To determine if the "sacral sparing" definition for completeness of traumatic spinal cord injury (SCI) is a more stable definition than the previously used Frankel Classification. DESIGN Retrospective analysis of persons enrolled in the Spinal Cord Injury Model Systems (SCIMS) database from 2011-2018. SETTING SCIMS centers. PARTICIPANTS Individuals (N=804) with traumatic SCI, age >16 years at time of injury, admission to rehabilitation within 30 days, ASIA Impairment Scale (AIS) grades A- D at admission, and complete neurological data at admission and 1-year. INTERVENTION None applicable. MAIN OUTCOME MEASURES Frankel and AIS scores were computed for a cohort of 804 eligible cases. Stability was compared between the two classification systems by calculating the proportions of cases where regression (conversion to a more severe impairment level) was observed. RESULTS A larger proportion of persons classified with "incomplete" injuries (grades B-D) at admission using the Frankel system regressed to complete status at 1-year compared to the AIS criteria (9.4% vs 2.0%). Those with B grade injuries regressed to A more often using Frankel as compared to the AIS system (19.7% to 5.4%). A larger proportion of people diagnosed as Frankel C or D regressed to Frankel A, as compared to AIS C or D who regressed to AIS A (5.0% to 1.1%). CONCLUSION Greater number of persons diagnosed with neurologically incomplete SCI regressed to complete status at 1-year when using the Frankel compared to the AIS classification which is based upon sacral sparing. This reinforces the finding that the "sacral sparing" definition is a more stable classification in traumatic SCI.

中文翻译：

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ASIA 损伤量表与 Frankel 分类系统对创伤性脊髓损伤的诊断稳定性的比较

目的 确定创伤性脊髓损伤 (SCI) 完整性的“骶骨保留”定义是否比以前使用的 Frankel 分类更稳定。设计 对 2011 年至 2018 年在脊髓损伤模型系统 (SCIMS) 数据库中登记的人员的回顾性分析。设置 SCIMS 中心。参与者 患有创伤性 SCI 的个体 (N=804)，受伤时年龄 >16 岁，入院后 30 天内康复，入院时 ASIA 损伤量表 (AIS) 等级为 A-D，入院时和 1 年有完整的神经学数据. 干预 无适用。主要结局指标 弗兰克尔和 AIS 评分是针对 804 名符合条件的病例进行计算的。通过计算观察到回归（转换为更严重的损伤水平）的案例比例，比较了两个分类系统之间的稳定性。结果 与 AIS 标准相比，在入院时使用 Frankel 系统归类为“不完全”损伤（BD 级）的人中有更大比例的人在 1 年时回归完全状态（9.4% 对 2.0%）。与 AIS 系统相比，那些 B 级受伤的人更常使用 Frankel 回归到 A 级（19.7% 至 5.4%）。与回归到 AIS A 的 AIS C 或 D 相比，被诊断为 Frankel C 或 D 的人回归到 Frankel A 的比例更大（5.0% 至 1.1%）。结论 与基于骶骨保留的 AIS 分类相比，当使用 Frankel 时，更多被诊断为神经学不完全性 SCI 的人在 1 年时回归完全状态。这强化了“骶骨保留”定义是创伤性 SCI 中更稳定的分类的发现。