Trauma / Spinal
ASIA Spinal Cord Injury Classification
International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Score motor and sensory function, determine neurological level, and classify injury severity using the ASIA Impairment Scale.
AIS BSensory Incomplete
NLIS1
InjuryIncomplete
0 = Total paralysis1 = Palpable/visible contraction2 = Active movement, gravity eliminated3 = Active movement, against gravity4 = Against some resistance5 = Against full resistance (normal)NT = Not testable
| Level | Muscle | Right (0-5) | Left (0-5) |
|---|---|---|---|
| C5 | Elbow flexors (Biceps) | ||
| C6 | Wrist extensors (ECR) | ||
| C7 | Elbow extensors (Triceps) | ||
| C8 | Finger flexors (middle finger) (FDP) | ||
| T1 | Finger abductors (little finger) (ADM) | ||
| L2 | Hip flexors (Iliopsoas) | ||
| L3 | Knee extensors (Quadriceps) | ||
| L4 | Ankle dorsiflexors (Tibialis ant.) | ||
| L5 | Long toe extensors (EHL) | ||
| S1 | Ankle plantar flexors (Gastroc/Sol) |
UE Right
25
UE Left
25
UEMS
50/50
LE Right
25
LE Left
25
LEMS
50/50
0 = Absent1 = Altered (impaired/hyperaesthesia)2 = NormalNT = Not testable
Cervical (C2-C8)
| Level | Light Touch | Pin Prick | ||
|---|---|---|---|---|
| R | L | R | L | |
C2Occipital protuberance | ||||
C3Supraclavicular fossa | ||||
C4Top of acromioclavicular joint | ||||
C5Lateral antecubital fossa | ||||
C6Thumb (dorsal surface) | ||||
C7Middle finger (dorsal surface) | ||||
C8Little finger (dorsal surface) | ||||
Thoracic (T1-T12)
| Level | Light Touch | Pin Prick | ||
|---|---|---|---|---|
| R | L | R | L | |
T1Medial antecubital fossa | ||||
T2Apex of axilla | ||||
T3Third intercostal space | ||||
T4Nipple line | ||||
T5Fifth intercostal space | ||||
T6Xiphisternum | ||||
T7Midway T6-T8 | ||||
T8Midway T6-T10 | ||||
T9Midway T8-T10 | ||||
T10Umbilicus | ||||
T11Midway T10-T12 | ||||
T12Inguinal ligament midpoint | ||||
Lumbar (L1-L5)
| Level | Light Touch | Pin Prick | ||
|---|---|---|---|---|
| R | L | R | L | |
L1Midway inguinal lig-L2 | ||||
L2Mid-anterior thigh | ||||
L3Medial femoral condyle | ||||
L4Medial malleolus | ||||
L5Dorsum of foot (3rd MTP) | ||||
Sacral (S1-S4/5)
| Level | Light Touch | Pin Prick | ||
|---|---|---|---|---|
| R | L | R | L | |
S1Lateral heel | ||||
S2Popliteal fossa | ||||
S3Ischial tuberosity | ||||
S4-5Perianal area | ||||
LT Right
56
LT Left
56
LT Total
112/112
PP Right
56
PP Left
56
PP Total
112/112
Sacral sparing determines whether the injury is complete or incomplete. Check S4-5 sensory scores above, then assess voluntary anal contraction and deep anal pressure below.
Voluntary Anal Contraction (VAC)
Deep Anal Pressure (DAP)
Incomplete Injury
Sacral sparing present: sensory or motor function preserved in sacral segments S4-5.
Classification Result
AIS Grade
B
Sensory Incomplete
Neurological Level
S1
Most cephalad level
Sensory Levels
Right
S4-5
Left
S4-5
Motor Levels
Right
S1
Left
S1
Total Motor
100/100
UEMS / LEMS
50 / 50
Light Touch
112/112
Pin Prick
112/112