Citation

Burns SP, Tansey KE. Spinal Cord 2020; ePub(ePub): ePub.

Affiliation

Spinal Cord Injury Clinic, Jackson VA Medical Center, Jackson, MS, USA.

Copyright

(Copyright © 2020, International Spinal Cord Society, Publisher Nature Publishing Group)

DOI

10.1038/s41393-020-0462-2

PMID

32249829

Abstract

The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) [1] is a comprehensive, thorough, and exhaustive clinical examination of segmental somatic sensory and motor function used to derive standardized neurological classifications. Many examiners and examinees would also describe the ISNCSCI as exhausting! The exam requires sensory testing of 28 dermatomes for light touch and sharp/dull discrimination bilaterally, manual muscle testing for ten key limb muscles bilaterally, plus an anorectal exam for sensation and motor function. In sum, this detailed exam of testable segments includes 134 items. At times, completion and recording of the exam can take in excess of 45 min, even for an experienced examiner.

Due to this time requirement, SCI care providers and other clinicians have been performing nonstandardized, abbreviated exams when the full exam and standardized classification is not required. Also, in circumstances when testing of the S4-5 dermatomes and an anorectal exam cannot be performed, there has been no alternative for assigning a neurologic classification. This limits community-based research projects in which neurologic status is merely being described and is not a study outcome. Clinicians and researchers have thus asked the International Standards Committee of the American Spinal Injury Association (ASIA) to develop a rigorous, shortened exam option that could be used in appropriate clinical or research applications. This could potentially include screening exams, daily exams, or periodic follow-up exams in those without new neurological complaints or changes in functional status.

In February 2020, after 3 years of development, the Expedited ISNCSCI (E-ISNCSCI) protocol was ...

Language: en