medigraphic.com
ISSN 2992-7749 (Electronic)
ISSN 2992-7897 (Print)
Órgano Oficial de difusión científica de la Asociación Mexicana de Cirujanos de Columna A. C. y de la Sociedad Iberolatinoamericana de Columna. SILACO.

Indizada en:

Scielo

2026, Number 3

<< Back Next >>

Cir Columna 2026; 4 (3)

Association between the level of spinal cord injury (thoracic, lumbar and sacral) and ASIA classification at admission in adults with acute spinal trauma: a retrospective cross-sectional study (2023-2025)

Ladewig BGI, Miguel ZA, Oropeza OE, Dufoo OM, Palacios SLA

Language: Spanish
References: 16
Page: 193-199
PDF size: 271.18 Kb.


ABSTRACT

Introduction: spinal cord injuries are associated with significant neurological and functional sequelae. The American Spinal Injury Association Impairment Scale (ASIA) is a standardized tool used to assess the severity of neurological impairment; however, the relationship between the anatomical level of spinal cord injury and ASIA classification has been sparsely documented. Objective: to evaluate the association between the anatomical location of spinal cord injury and the degree of neurological impairment according to the ASIA scale in adults with acute spinal trauma. Material and methods: a retrospective cross-sectional correlational study was conducted. Medical records of patients aged ≥ 18 years with vertebral fractures treated at the Spine Clinic of a public hospital in Mexico City between January 2023 and January 2025 were reviewed. Demographic and clinical variables were collected, including age, type of injury (fracture), affected spinal cord segment (thoracic, lumbar, or sacral), involved vertebra, ASIA classification at admission, associated injuries, and surgical treatment. The association between the affected segment and ASIA grade was assessed using the χ2 test. Results: a total of 192 medical records were included, with a median age of 34.0 years (IQR 24.0-48.75). The lumbar segment was the most frequently affected, followed by the thoracic and sacral segments. The most commonly involved vertebra was L1. At admission, ASIA grade D was the most frequent, followed by grades C, B, and A. Most patients were treated with surgical instrumentation. A statistically significant association was identified between the affected spinal cord segment and the degree of neurological impairment according to the ASIA scale (χ2, p < 0.001). Conclusion: a significant association exists between the anatomical level of spinal cord injury and the severity of neurological impairment as assessed by the ASIA scale at admission. These findings highlight the importance of considering injury location during initial evaluation and therapeutic planning, as well as for prognostic stratification in patients with acute spinal trauma.


REFERENCES

  1. Hu X, Xu W, Ren Y, Wang Z, He X, Huang R, et al. Spinal cord injury: molecular mechanisms and therapeutic interventions. Signal Transduct Target Ther. 2023; 8 (1): 1-27.

  2. Silva R, Castro M, Rojas P. Manejo quirúrgico de las fracturas toracolumbares: abordajes contemporáneos. Acta Ortop Mex. 2022; 36 (2): 120-128.

  3. De Ruz AE. Traumatic spinal cord injury: comprehensive assessment and management. Medicine - Programa de Formación Médica Continuada Acreditado. 2019; 12 (75): 4387-4400. Available in: https://doi.org/10.1016/j.med.2019.03.020

  4. Barbiellini Amidei C, Salmaso L, Bellio S, Saia M. Epidemiology of traumatic spinal cord injury: a large population-based study. Spinal Cord. 2022; 60 (9): 812-819.

  5. Anjum A, Yazid MD, Daud MF, Idris J, Ng AMH, Naicker AS, et al. Spinal cord injury: pathophysiology, multimolecular interactions, and underlying recovery mechanisms. Int J Mol Sci. 2020; 21 (20): 7533.

  6. Organización Mundial de la Salud (OMS). Lesiones de la médula espinal: perspectivas internacionales. Malta: OMS; 2014.

  7. Kumru H, Flores A, Rodríguez-Cañón M, Soriano I, García L, Vidal-Samsó J. Non-invasive brain and spinal cord stimulation for motor and functional recovery after a spinal cord injury. Rev Neurol. 2020; 70 (12): 461-477.

  8. Instituto Mexicano del Seguro Social. Informe epidemiológico anual: lesión medular traumática en México 2023. Ciudad de México: IMSS; 2023.

  9. Torres M. Aspectos epidemiológicos de la lesión medular en el Hospital Nacional de Parapléjicos. Ene. 2018; 12 (21): 122.

  10. Fawcett J, Curt A. Spinal cord injury: recovery, repair, and translational neuroscience. Nat Rev Neurol. 2021; 17 (3): 173-188.

  11. Kwon BK, Streijger F, Ramer LM. Pathophysiology and emerging therapies for spinal cord injury. Nat Rev Neurol. 2019; 15 (12): 673-689.

  12. Arriagada G, Macchiavello N. Spinal cord injury (SCI): bibliographic review. Rev Med Clin Las Condes. 2020; 31 (5-6): 423-429.

  13. Mireles-Cano J, Escoto-Venegas E, García-González O, Miranda-González A, González-Ramírez J, Hernández-Sepúlveda E, et al. Algoritmo de manejo para el síndrome de destrucción vertebral por mieloma múltiple y compresión metastásica de la médula espinal. Acta Ortop Mex. 2020; 34 (5): 293-297.

  14. Estrada-Mondaca S, Carreón-Rodríguez A, Parra-Cid M, Ibarra-Ponce de León C, Velasquillo-Martínez C, Vacanti C, et al. Lesión de médula espinal y medicina regenerativa. Salud Publica Mex. 2007; 49 (6): 437-444.

  15. Montero MF. Actualización sobre la situación de la lesión medular en América Latina: retos y oportunidades en su atención. Rev Colomb Med Fis Rehabil. 2022; 32: 238-248.

  16. Collignon F, Martin D, Lénelle J, Stevenaert A. Acute traumatic central cord syndrome: magnetic resonance imaging and clinical observations. J Neurosurg. 2002; 96 (1): 29-33.




2020     |     www.medigraphic.com