Definition of Incomplete Spinal Cord Injury

WiseY wisey at aol.com
Sun Apr 23 01:33:47 EST 1995


santitor at bnr.ca (Sarah.Santitoro) writes on 19 Apr 1995 14:40:58 GMT that:
I am unfamiliar with the term "incomplete" in relating to spinal cord
injuries.  Do you mean an injury where the patient is still able to retain
a high level of activity in the area that was damaged?  Also, are you
interested in related trauma that develop independantly to outside
influence (like diseases, malformations, cysts...)?
----
The clinical term "incomplete" when applied to spinal cord injury
indicates that the patient has some sensory or motor function below the
lesion level.  As defined recently in the International and American
Spinal Injury Association (ASIA) Neurological Classification of Spinal
Cord Injury, the term has been given an even more specific meaning,
indicating a person with preservation motor or sensory function in the
last sacral segment (S4-5).  This definition gets around the problem often
encountered in the clinical setting of a patient who has an injury at a
given level, some preserved sensation or motor function or several
segments, and then no function below that level.  By defining incomplete
as having some function at the lowest level of the spinal cord, the
definition become unambiguous.  A more controversial term relates to the
word "complete" when applied to spinal cord injury.  By the ASIA
definition, a person that does not have preserved sacral sensory or motor
function should be "complete".  Unfortunately, the term has connotations
of complete loss and a finality that is not desirable.  Some patients with
complete loss of neurological function below the lesion level may still
recovery several segments, especially when treated shortly after injury. 
I am sure that this is probably more than you ever wanted to know on this
subject.  

See the following references for more details:
1. Ditunno JFJ, Young W, Donovan WH, Bracken MB, Brown M, et al. 
Standards for Neurological Classification of Spinal Cord Injury.  American
Spinal Injury Association, Chicago, 1992.
2. Ditunno J, Jr., Young W, Donovan WH, Creasey G (1994).  The
international standards booklet for neurological and functional
classification of spinal cord injury. American Spinal Injury Association. 
Paraplegia 32: 70-80.

Wise Young, NYU Medical Center.



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