How is the neurologic level of spinal cord injury (SCI) assessed?

Updated: Nov 01, 2018
  • Author: Lawrence S Chin, MD, FACS, FAANS; Chief Editor: Brian H Kopell, MD  more...
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Neurologic level of injury is the most caudal level at which motor and sensory levels are intact, with motor level as defined above and sensory level defined by a sensory score of 2.

Zone of partial preservation is all segments below the neurologic level of injury with preservation of motor or sensory findings. This index is used only when the injury is complete.

The key muscles that need to be tested to establish neurologic level are as follows:

  • C5: Elbow flexors (biceps, brachialis)

  • C6: Wrist extensors (extensor carpi radialis longus and brevis)

  • C7: Elbow extensors (triceps)

  • C8: Long finger flexors (flexor digitorum profundus)

  • T1: Small finger abductors (abductor digiti minimi)

  • L2: Hip flexors (iliopsoas)

  • L3: Knee extensors (quadriceps)

  • L4: Ankle dorsiflexors (tibialis anterior)

  • L5: Long toe extensors (extensor hallucis longus)

  • S1: Ankle plantar flexors (gastrocnemius, soleus)

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