For this ASIA case, why is the patient an AIS A complete when the NLOI is C4 and there is motor activation at C7 which is 3 levels below the NLOI? Wouldn’t this technically make the patient an AIS C?
To be classified as an AIS C, this patient would need either (1) voluntary anal sphincter contraction or (2) sacral sensory sparing AND motor function MORE than 3 levels below the motor level.
If this patient had sacral sensory sparing with his motor scores, he would be classified as an AIS B. His motor sparing is 3 levels below the motor level (C7), but not MORE than 3 levels. If he had sacral sensory sparing and motor function to C8, he would then be classified as AIS C.
On the second page of the ISNCSCI form, you can find these criteria in the footnote (marked with a **) in the middle column.
They would still be an AIS A without sacral sparing. They could actually have functional strength in their legs without any sacral sparing and still be an AIS A. In some cases, the ISNCSCI classification is not always consistent with functional ability.