Trajectory of ASIA Grade Improvement in Incomplete Traumatic Spinal Cord Injury Following Surgical Decompression: A Quasi-experimental Study in Bangladesh

Authors

  • Md Kamrul Ahsan Professor of Spinal Surgery, Department of Orthopaedic Surgery, Bangladesh Medical University, Dhaka, Bangladesh
  • Md Kamruzzaman Registrar, Department of Orthopaedics, IBN SINA Medical College Hospital, Dhaka, Bangladesh
  • Shahidul Islam Khan Assistant Professor, Department of Orthopaedic Surgery, Bangladesh Medical University, Dhaka, Bangladesh
  • Abdullah Al Mahmud Assistant Professor, Department of Orthopaedic Surgery, IBN Sina Medical College, Dhaka, Bangladesh
  • Md Hamidul Haque Assistant professor, Department of Orthopaedic Surgery, IBN Sina Medical College, Dhaka, Bangladesh
  • Md Faiyaz Ahsan Medical Officer, Department of Orthopaedic Surgery, Bangladesh Medical College, Dhaka, Bangladesh
  • Mohua Zaman Medical Officer, Department of Orthopaedic Surgery, Bangladesh Medical College, Dhaka, Bangladesh
  • Md Faruq Mia Resident, Department of Orthopaedic Surgery, Bangladesh Medical University, Dhaka, Bangladesh
  • Md Shahidul Islam Akon Associate Professor Department of Orthopaedic Surgery, Dhaka Medical College, Dhaka, Bangladesh
  • Md Shah Alam Professor of Orthopaedics & Chief Consultant, Department of Orthopaedics, Bangladesh Spine and Orthopaedic Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/bjms.v25i1.86409

Keywords:

traumatic spinal cord injury; ASIA grade conversion; spinal decompression; quasi-experimental study; Bangladesh

Abstract

Background Traumatic spinal cord injury (TSCI) often leads to severe neurological impairment. Surgical decompression is a widely used intervention, but the extent and timeline of neurological recovery—particularly ASIA grade conversion—remain insufficiently documented in developing countries. Objective To evaluate ASIA grade improvement following surgical management in patients with incomplete TSCI. Methods This quasi-experimental study enrolled 38 patients with incomplete TSCI, who underwent surgical decompression across four tertiary hospitals in Dhaka, Bangladesh. ASIA impairment scale grades were recorded at admission and at 1, 3, and 6 months postoperatively. Statistical analysis included the Friedman test and chi-square tests to assess grade transitions. All statistical analysis were done by SPSS version 26.0 Results The mean age was 37.5 years, with male predominance (86.8%). Fall from height (63.2%) was the most common mechanism of injury, and L1 was the most frequently affected level (63.3%). At admission, most patients were ASIA D (60.5%). At 6 months, 81.6% improved to ASIA E. Overall, 97.4% experienced at least one-grade improvement, with conversion rates of 83.3% for ASIA B, and 100% for ASIA C and D. The Friedman test indicated a statistically significant improvement across time points (p = 0.001). Conclusion Surgical decompression in patients with incomplete TSCI is associated with substantial neurological recovery. ASIA grade conversion can serve as a reliable marker for monitoring surgical outcomes in such patients.

BJMS, Vol. 25 No. 01 January’26 Page : 112-117

 

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Author Biography

Md Kamrul Ahsan, Professor of Spinal Surgery, Department of Orthopaedic Surgery, Bangladesh Medical University, Dhaka, Bangladesh

 

 

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Published

2026-01-26

How to Cite

Ahsan, M. K., Kamruzzaman, M., Khan, S. I., Mahmud, A. A., Haque, M. H., Ahsan, M. F., … Alam, M. S. (2026). Trajectory of ASIA Grade Improvement in Incomplete Traumatic Spinal Cord Injury Following Surgical Decompression: A Quasi-experimental Study in Bangladesh. Bangladesh Journal of Medical Science, 25(1), 112–117. https://doi.org/10.3329/bjms.v25i1.86409

Issue

Vol. 25 No. 1 (2026)

Section

Original Articles

License

Copyright (c) 2026 Md. Kamrul Ahsan, Md. Kamruzzaman, Shahidul Islam Khan, Abdullah Al Mahmud, Md, Hamidul Haque, Md. Faiyaz Ahsan, Mohua Zaman, Md. Faruq Mia, Md. Shahidul Islam Akon, Md Shah Alam

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