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Hello!
I have a question regarding exam 4 question 2:
You are evaluating a 17-year-old male who has sustained a spinal cord injury. During your assessment, you note that there is muscle activity throughout the core and with hip flexion being graded 5/5. Knee extension is 3+/5 and there is no active ankle dorsiflexion or ankle plantarflexion. There is no sensation reported behind the knee or at the ankle.
What level spinal cord injury do you suspect for this patient?
Thinking about ISNCSCI levels, if L2 is 5/5 and L3 is 3+/5, wouldn’t that indicate that the level is L2? I am confused how the answer is L3.
Thank you!
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Hi! The motor level is defined as the “lowest key muscle function that has a grade of at least 3, providing the key muscle functions represented by segments above that level are judged to be intact (5/5).”
This patient has full strength in his hip flexors (L2) and 3+/5 strength in his knee extensors (L3). Therefore, L3 is the lowest level with a grade of at least 3/5 with proximal musculature having full strength.
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