The revised zone of partial preservation (ZPP) in the 2019 International Standards for Neurological Classification of Spinal Cord Injury

• Verfasst von: Schuld, Christian [VerfasserIn]
• Verfasst von: Kirshblum, Steven [VerfasserIn]
• Verfasst von: Tansey, Keith [VerfasserIn]
• Verfasst von: Rupp, Rüdiger [VerfasserIn]
• Titel: The revised zone of partial preservation (ZPP) in the 2019 International Standards for Neurological Classification of Spinal Cord Injury
• Titelzusatz: ZPP applicability in incomplete injuries
• Verf.angabe: Christian Schuld, EMSCI study group, Steven Kirshblum, Keith Tansey, ASIA International Standards Committee and Rüdiger Rupp
• E-Jahr: 2024
• Jahr: 08 January 2024
• Umfang: 9 S.
• Illustrationen: Illustrationen
• Fussnoten: Online veröffenlicht: 8. Januar 2024 ; Gesehen am 06.05.2024
• Titel Quelle: Enthalten in: Spinal cord
• Ort Quelle: Basingstoke : Stockton Press, 1996
• Jahr Quelle: 2024
• Band/Heft Quelle: 62(2024), 2, Seite 79-87
• ISSN Quelle: 1476-5624
• DOI: doi:10.1038/s41393-023-00950-x
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Outcomes research
• Sach-SW: Spinal cord diseases
• K10plus-PPN: 1887879315

Abstract

Study design: Consensus process. Objectives: To provide a reference for the Zone(s) of Partial Preservation (ZPP) in the 2019 International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) and analyze the initial impact of applicability of the revised ZPPs. Revisions include the use of ZPPs in selected incomplete injuries (in addition to prior use in sensorimotor complete injuries). Specifically, the revised motor ZPPs are applicable bilaterally in injuries with absent voluntary anal contraction (VAC) and the revised sensory ZPP for a given side is applicable if deep anal pressure (DAP), light touch and pin prick sensation in S4-5 are absent on that side. Setting: Committee with 16 ISNCSCI experts and datasets from the European Multicenter Study about Spinal Cord Injury (EMSCI). Methods: Occurrence frequencies of applicable ZPPs were determined in an EMSCI cohort consisting of two ISNCSCI examinations from 665 individuals with traumatic SCI. Results: Motor ZPPs were derived in 35.2% of all datasets of incomplete injuries, while sensory ZPPs are much less frequent (1.0%). Motor ZPPs are applicable in all American Spinal Injury Association Impairment Scale (AIS) B datasets (mean ZPP length: 0.9 ± 1.0 segments), in 55.4% of all AIS C datasets (ZPP length: 11.8 ± 8.2 segments) and in 9.9% of the AIS D datasets (ZPP length: 15.4 ± 7.9 segments). Conclusions: The revised ZPP allows for determining motor ZPPs in approximately 1/3 of all incomplete injuries. The broadened applicability enables the use of ZPPs beyond complete injuries for complementary description of residual functions in more individuals.