SCI

Question 1

Neurologic Level of Injury

Answer 1

Sensory: most caudal, intact dermatome for both pinprick and light touch sensation (lowest level rated 2 for pinprick and light touch)

Motor: lowest key muscle functional with grade of at least 3, with key muscles above graded as 5

In regions where there is no myotome to test, motor level = sensory level

Question 2

Complete vs. Incomplete SCI

Answer 2

Complete:
- absent voluntary anal contraction
- absent deep anal pressure (DAP)
- all S4-5 sensory scores = 0

Incomplete: if any criteria for complete injury are not met

Question 3

ASIA A

Answer 3

Complete

No sensory or motor function is preserved in the sacral regions

Question 4

ASIA B

Answer 4

Sensory Incomplete

Sensory but no motor function is preserved below the neurological level and includes the sacral segments S4-5 (light touch/pinprick and DAP)

No motor function is preserved more than 3 levels below the motor level on either side of body.

Question 5

ASIA C

Answer 5

Motor Incomplete

Motor function is preserved below the neurologic level of injury

More than half of key muscles below the neurological level of injury have a grade of less than 3.

Question 6

ASIA D

Answer 6

Motor Incomplete

Motor function is preserved below the neurologic level of injury

At least half of key muscles below the neurologic level of injury have a grade of =/>3.

Question 7

ASIA E

Answer 7

Normal

If sensation and motor function are normal in all segments, and the patient had prior deficits, then the AIS grade is E.

Question 8

Zone of Partial Preservation (ZPP)

Answer 8

If deep anal pressure sensation (DAP) is present, then there is NO sensory ZPP. And if voluntary anal contraction (VAC) is present, then there is NO motor ZPP. If either is absent, then there is a ZPP.

Question 9

Positive Prognostic Factors

Answer 9

-Incomplete injury
-Vertebral displacement <30%
-Age <30 years at time of injury
-Faster initial recovery
-Lower level of injury
-Higher initial strength