ASIA Impairment Scale (AIS)

Spinal Cord Injuries are classified in general terms of being neurologically “Complete” or “Incomplete” based upon Sacral Sparing, which refers to the
presence of Sensory or Motor Function in the most Caudal Sacral Segments i.e. preservation of light touch or pin prick sensation at S4-5 Dermatome, Deep
Anal Pressure or Voluntary Anal Sphincter Contraction.[2]

Complete Injury: Absence of Sacral Sparing i.e. No Sensory and Motor Function at S4-5

Incomplete Injury: Presence of Sacral Sparing i.e. Partial preservation of Sensory and/or Motor Function at S4-5

Sensory Incomplete: Sacral Sparing of Sensory Function

Motor Incomplete: Sacral Sparing of Motor Function or Sacral Sparing of Sensory and Motor Function more than 3 Levels below Injury

The following ASIA Impairment Scale (AIS) designation is used in grading the degree of impairment:

Grade Type of Injury Description of Injury

A Complete No Sensory or Motor Function is preserved in the Sacral Segments S4-S5
B Sensory Incomplete Sensory but not Motor Function is preserved below the neurological level and includes the Sacral Segments S4-S5,
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 below the Neurological Level

AND

More than half of key muscle functions below the Neurological Level of Injury have a muscle grade less than 3 (Grades 0-2)

D Motor Incomplete Motor function is preserved below the neurological level

AND

At least half (half or more) of key muscle functions below the NLI have 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 a Spinal Cord Injury does not receive an AIS Grade.
ASIA Impairment Scale (AIS) [2]

Incomplete injuries are further categorized under 5 types as per their clinical presentation. They are:

1. Brown-Sequard Syndrome
2. Anterior Cord Syndrome
3. Posterior Cord Syndrome
4. Conus Medullaris Syndrome
5. Cauda Equina Syndrome