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    • #489010
      Taylor Barilla


      I was hoping to get clarification regarding level grading for spinal cord injury. There was a specific question in the Case Based Exam (case 4) that asks to identify the level of spinal cord injury, given the muscle grades provided.

      Given the information in Campbell on page 508: “The ASIA defined motor level is the most caudal root level in which muscle strength is grade 3 or more and the next rostral muscle is grade 5.” I understand which key muscles generate the specific motor movements, although I do not understand why I got the answer to this question wrong, based on this information from Campbell.

      Any help would be greatly appreciated!

    • #489012
      Jessica Lewis

      I think the confusion for this question is that we should have clarified if we were looking for the sensory, motor, or neurological level of injury. The correct answer for this one is referring to the motor level of injury – defined by the lowest key muscle function that has a grade of at least 3 (on supine testing).

      If we were looking for the neurological level your definition would be correct.

      Sorry for the confusion! We will be sure to make a change to clarify that we are looking for the motor level for this one.

    • #489018
      Bri Hohl

      I had the same question about this item. Motor level is indeed defined as the lowest key muscle that has a grade of at least 3 BUT with the above muscles grade 5. If the above muscles are not grade 5, then that is not the motor level but rather indicative of an incomplete SCI. Based on ASIA testing, the motor level should indeed have been L2 (because hip flexors were 4/5 and not 5/5, and that is assuming the next rostral muscle was 5/5 even though that information was not stated) and then the patient would either have a ZPP or be ASIA C depending on the results from the remaining sensory and motor testing.

      • This reply was modified 3 weeks, 3 days ago by Bri Hohl.
      • This reply was modified 3 weeks, 3 days ago by Bri Hohl.
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