myelopathy. In common parlance the term injury is often used for all forms of damage. In this study
the term SCI is used.
A SCI is an interruption of the nerves in the spinal cord. This results in loss of muscle strength,
sensory function and problems of the autonomic nervous syste
The severity of the spinal cord
injury depends on the level and completeness of the lesion.
3
To make a clear description of the condition of a person with SCI the American Spinal Injury
Association (ASIA) developed the International Standards for Neurological and functional
Classification of Spinal Cord Injury (ISNCSCI). A neurological examination of the patient in supine is
hereby made. The examination is limited to the bilateral measurement of muscular strength of ten
key muscle groups, based on MRC-scale, and of sensibility at bilateral twenty eight test points on the
skin. With the results the lesion level can be determined. This gives a clear and internationally
comparable description of the neurological conditio
SCI are classified by being complete or incomplete. A SCI injury is considered to be complete when no
sensory or motor function is preserved in the lower sacral segment S4-S5. The presence of the deep
anal feeling can sometimes be the only indication that there is an incomplete spinal cord injury. The
ASIA Impairment Scale (table I) is used internationally in grading the degree of impairment
Persons with SCI can further be classified according to the lesion level into two groups, tetraplegia
and paraplegia. Tetraplegia implies to a lesion in the cervical segments of the spinal cord. This results
in impairment of sensory and/or motor functions in all the levels below the injury including the four
extremities, trunk and pelvic organs. Paraplegia refers to a lesion under the cervical segments.
Therefore the function of the upper extremity is normal, but the function in the lower extremities
and trunk are impaired
Table I
‘ASIA Impairment Scale’
A
: Complete
No sensory function or motor function is preserved in the sacral segments S4-S5
B
: Sensory
Incomplete
Sensory function is preserved below the neurological level, but not motor function and
includes the sacral segments S4-S5. AND no motor function is preserved more than three
levels below the motor level on either side of the body
C
: Motor
Incomplete
Motor function is preserved below the neurological level and more than the half of key
muscle functions below the neurological level have a muscular strength less than grade 3
D
: Motor
Incomplete
Motor function is preserved below the neurological level and at least half of key muscle
functions below the neurological level have a muscular strength more than grade 3
E
: Normal
Sensory function and motor function are normal in all segments and patient had prior deficits
