Development and validation of the electrosacrogram (ESG): a digital point-of-care tool for real-time neuro-sacral assessment after spinal cord injury.
Maude Duguay, Jean-Marc Mac-Thiong, Juan-David Cifuentes-Hernandez and 2 others
PMID 41382214WHAT IT FOUND
A bedside electrical muscle test quantified sacral squeeze and sensation after spinal cord injury.
It matched rectal exam for squeeze and sensation, not resting tone, and a normal result did not rule out pathology.
Key findings
01In 74 patient ESG tests, ESG detected radiological spinal pathology with 83.3% sensitivity and 100% specificity, and overall accuracy was 86.5%.
02In 62 ESG exams from neurologically impaired patients, ESG agreed with expert rectal exam for 95% of voluntary squeeze tests and 97% of sensory tests, but only 82% of resting tone tests.
03ESG values separated into two domains: motor resting tone and voluntary squeeze, and sensory/reflex bulbospongious reflex and electrical perceptual threshold.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study did not follow patients over time to see whether ESG changes predicted recovery. Patients had to be able to cooperate with squeeze and sensation testing, so results may not apply to people with altered consciousness, severe pain or cognitive impairment. Resting anal tone agreement with the rectal exam was poor, and no single ESG parameter independently confirmed neurogenic impairment. A normal ESG did not fully exclude spinal pathology. The study did not perform anorectal manometry, so ESG values cannot be related to anal pressure measurements. Formal reliability testing and larger multicentre validation are still needed.
Declared interests
Funding was reported from the Chaire de Recherche Medtronic en Traumatologie Spinal, the Craig H. Neilsen Foundation and the Canadian Institutes of Health Research. No author conflict-of-interest statement is included in the supplied text.
The easy way to misread this
Do not conclude ESG is ready to replace rectal exam or rule out spinal pathology. It was a single-site, cross-sectional validation with no longitudinal outcomes, and a normal ESG did not fully exclude pathology.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →