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The spinal cord is the major collection of nerves that communicate muscle movement and sensation

to and from the brain and the rest of the body. It is surrounded by a column of bony rings called

vertebrae. The nerves that travel from the brain to the tailbone, together with this column of bones

is called the spine.

An injury to the spine may cause the bones around the spinal cord to break and press against the

spinal cord, which can damage the nerves, breaking the communication path and affecting

movement and sensation.

In addition to movement and sensation, the spinal cord carries nerves signals that affect and control

other body systems such as skin, bowel, bladder, and breathing. So, damage to the spinal cord,

depending on the completeness of the injury, may cause these body functions not to work the same

as before.

Classification

The American Spinal Injury Association (ASIA) first published an international classification of spinal cord injury in 1982, called the International Standards for Neurological and Functional Classification of Spinal Cord Injury. Now in its sixth edition, the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) is still widely used to document sensory and motor impairments following SCI. It is based on neurological responses, touch and pinprick sensations tested in each dermatome, and strength of the muscles that control ten key motions on both sides of the body, including hip flexion (L2), shoulder shrug (C4), elbow flexion (C5), wrist extension (C6), and elbow extension (C7).[Traumatic spinal cord injury is classified into five categories on the ASIA Impairment Scale:

 

• A indicates a “complete” spinal cord injury where no motor or sensory function is preserved
in the sacral segments S4-S5.

 

• B indicates an “incomplete” spinal cord injury where sensory but not motor function is

preserved below the neurological level and includes the sacral segments S4-S5. This is

typically a transient phase and if the person recovers any motor function below the

neurological level, that person essentially becomes a motor incomplete, i.e. ASIA C or D.

 

• C indicates an “incomplete” spinal cord injury where motor function is preserved below the

neurological level and fewer than half of key muscles below the neurological level have a

muscle grade of 3 or more (active movement with full range of motion against gravity).

 

• D indicates an “incomplete” spinal cord injury where motor function is preserved below the

neurological level and at least half of the key muscles below the neurological level have a

muscle grade of 3 or more.

 

• E indicates “normal” where motor and sensory scores are normal. It is possible to have

spinal cord injury and neurological deficits with completely normal motor and sensory

scores.

 

 

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