Neurological Examination in Spinal Cord Injury and Determination of Neurological Level

Introduction

Accurate neurological examination is crucial in assessing spinal cord injuries (SCI). It helps determine the neurological level, guiding treatment strategies and prognosis.

Complete vs. Incomplete Spinal Cord Injuries

Complete SCI

A complete spinal cord injury results in the total loss of motor and sensory functions below the level of injury.

Incomplete SCI

In an incomplete spinal cord injury, some degree of motor or sensory function remains below the level of injury.

Neurological Examination

Sensory Assessment

• Light touch and pinprick sensation testing
• Dermatomal mapping to localize the level of injury

Motor Assessment

• Testing of key muscle groups based on the American Spinal Injury Association (ASIA) scale
• Grading muscle strength from 0 (no movement) to 5 (normal function)

ASIA Impairment Scale

The ASIA scale categorizes injuries as complete (A) or incomplete (B, C, D, E) based on neurological function.

Conclusion

Precise neurological assessment plays a pivotal role in managing SCI, impacting treatment outcomes and rehabilitation plans.