Case based quiz 9

[Alex Turcios]

In this SCI case based quiz, the question ask for AIS grade. The correct answer is AIS D. But if they have no voluntary anal contraction, shouldent they be a B? They do have deep anal pressure

[Alex Turcios]

I went back to the lecture, so let me know if this is correct. In order to be AIS B you must: have deep anal pressure (this will make one sensory incomplete) and they must have no anal contraction IN ADDITION to not having muscle scores for 3 muscles below the level of SCI?
So if one has no anal contraction and 5/5 T1 (finger abduction) and sensation of 2/2 at T11, but no muscle strength on L2 and below, they would still be a AIS C?

[Chrissy Durrough Lugge]

AIS B injuries are sensory incomplete AND motor complete. To be sensory incomplete, one must have sensation in the lowest sacral segments. This can be met in two ways: (1) light touch or pinprick preserved at S4-5, OR (2) deep anal pressure. To be motor complete, one must not have voluntary anal contraction AND no motor function more than three levels below the neurological level of injury.

The example you outlined (no VAC, 5/5 T1 MMT, sensation intact to T11, 0/5 MMT in BLE) is an example of an AIS B injury. Assuming strength and sensation are normal above T11, the person would have a neurologic level of injury of T11. All muscle groups below T11 were 0/5 and there is not voluntary anal contraction – making this a sensory incomplete injury (AIS B).

[Alex Turcios]

Do we not count the muscles of the trunk that are assumed intact when its respective sensation is intact?

[Chrissy Durrough Lugge]

Nope – we don’t make assumptions in this case. Only testable muscle groups count. You can include key and non-key muscle groups.

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