American Spinal Injury Association (ASIA) impairment scale (AIS)

A = Complete. No sensory or motor function is preserved in the sacral segments S4-5.

B = Sensory incomplete. Sensory but not motor function is preserved below the neurologic level and includes the sacral segments S4-5 (light touch or pin prick at S4-5 or deep anal pressure) AND no motor function is preserved more than three levels below the motor level on either side of the body.

C = Motor incomplete. Motor function is preserved at the most caudal sacral segments for voluntary anal contraction (VAC) OR the patient meets the criteria for sensory incomplete status (sensory function preserved at the most caudal sacral segments S4-5 by LT, PP or DAP), and has some sparing of motor function more than three levels below the ipsilateral motor level on either side of the body.
(This includes key or non-key muscle functions to determine motor incomplete status.) For AIS C – less than half of key muscle functions below the single NLI have a muscle grade ≥3.

D = Motor incomplete. Motor incomplete status as defined above, with at least half (half or more) of key muscle functions below the single NLI having a muscle grade ≥3.

E = Normal. If sensation and motor function as tested with the ISNCSCI are graded as normal in all segments, and the patient had prior deficits, then the AIS grade is E. Someone without an initial SCI does not receive an AIS grade.

Using ND: To document the sensory, motor and NLI levels, the ASIA Impairment Scale grade, and/or the zone of partial preservation (ZPP) when they are unable to be determined based on the examination results.

Muscle function is graded using the International Standards for Neurologic Classification of Spinal Cord Injury.
For an individual to receive a grade of C or D (ie, motor incomplete status), he or she must have either (1) voluntary anal sphincter contraction or (2) sacral sensory sparing with sparing of motor function more than three levels below the motor level for that side of the body.
Patients without an initial spinal cord injury do not receive an AIS grade.

LT: light touch; PP: pin prick; DAP: deep anal pressure; NLI: neurologic level of injury; ISNCSCI: International Standards for Neurologic Classification of Spinal Cord Injury; SCI: Spinal cord injury.

Graphic 60383 Version 10.0

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American Spinal Injury Association (ASIA) impairment scale (AIS)