How is sensory function testing performed in the evaluation of spinal cord injury (SCI)?

Updated: Nov 01, 2018
  • Author: Lawrence S Chin, MD, FACS; Chief Editor: Brian H Kopell, MD  more...
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Answer

Assessment of sensory function helps to identify the different pathways for light touch, proprioception, vibration, and pain. Use a pinprick to evaluate pain sensation.

Sensory level is the most caudal dermatome with a normal score of 2/2 for pinprick and light touch.

Sensory index scoring is the total score from adding each dermatomal score with a possible total score of 112 each for pinprick and light touch.

Sensory testing is performed at the following levels:

  • C2: Occipital protuberance

  • C3: Supraclavicular fossa

  • C4: Top of the acromioclavicular joint

  • C5: Lateral side of antecubital fossa

  • C6: Thumb

  • C7: Middle finger

  • C8: Little finger

  • T1: Medial side of antecubital fossa

  • T2: Apex of axilla

  • T3: Third intercostal space

  • T4: Fourth intercostal space at nipple line

  • T5: Fifth intercostal space (midway between T4 and T6)

  • T6: Sixth intercostal space at the level of the xiphisternum

  • T7: Seventh intercostal space (midway between T6 and T8)

  • T8: Eighth intercostal space (midway between T6 and T10)

  • T9: Ninth intercostal space (midway between T8 and T10)

  • T10: 10th intercostal space or umbilicus

  • T11: 11th intercostal space (midway between T10 and T12)

  • T12: Midpoint of inguinal ligament

  • L1: Half the distance between T12 and L2

  • L2: Midanterior thigh

  • L3: Medial femoral condyle

  • L4: Medial malleolus

  • L5: Dorsum of the foot at third metatarsophalangeal joint

  • S1: Lateral heel

  • S2: Popliteal fossa in the midline

  • S3: Ischial tuberosity

  • S4-5: Perianal area (taken as 1 level)


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