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Thread: complete or incomplete?

  1. #1

    complete or incomplete?

    Hello everybody. I wanted to ask....I'm a c5/6 complete, but I can feel my lower back muscles, ab muscles and fingers contract when I get spasms so does this make me incomplete to some degree?

  2. #2
    Not according to the ASIA standards, but of course this does mean technically that you have some pathways that are still intact through your injury area. For the ASIA standards you would have to have at least sensation at your anus:

    http://sci.rutgers.edu/index.php?pag...nalLevels.html

    (KLD)

  3. #3
    Quote Originally Posted by SCI-Nurse
    For the ASIA standards you would have to have at least sensation at your anus
    That's just dumb. It makes no sense to say that someone who has broken their neck, but can still use their arms and hands is "complete" just because they can't feel their butt.

    C.

  4. #4
    Senior Member jb's Avatar
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    there are zones of partial preservation

  5. #5
    Quote Originally Posted by Tiger Racing
    That's just dumb. It makes no sense to say that someone who has broken their neck, but can still use their arms and hands is "complete" just because they can't feel their butt.
    Agreed. Similarly, if someone can feel their butt but have no feeling or control over anything else from neck down, they're called incomplete. The term doesn't have a lot of practical meaning to the individual; it just indicates that a pathway from top to bottom exists somewhere.
    I suppose it does mean that there's more hope of recovery for an incomplete, but I don't have a feeling for the statistics. Slim, I expect (barring a breakthough in the hopefully near future).
    - Richard

  6. #6
    Quote Originally Posted by QuadPro
    Hello everybody. I wanted to ask....I'm a c5/6 complete, but I can feel my lower back muscles, ab muscles and fingers contract when I get spasms so does this make me incomplete to some degree?
    Since I was in part responsible for proposing this definition, I should rise to its defense. In 1990, when I was co-chairing the ASIA committee on defining the classification of spinal cord injury, there were many definitions of "complete" and "incomplete" injuries, depending on the levels of partially preserved segments, how long the examination was done after injury, etc. Doctors were using the definition of "complete" injury almost in a punitive way, depriving people of hope of any recovery. It was simply not true that complete meant no recovery and yet many doctors were predicting to patients that they would not recover any function early after their injury.

    So, I proposed the following definition of ASIA A. A person would have an ASIA A classification if that person has some spinal level below which he or she has no motor and sensory function. Since the anal area is the lowest level of the spinal cord, the absence of any sensation or motor function in the anus became the automatic definition of "complete". Of course, one needs to indicate the level of the "complete" loss of voluntary motor and sensory function.

    Many studies have been carried out to assess the impact of this new definition since 1991. It turns out that this one finding (anal sensation and voluntary sphincter function) does predict the extent of recovery. Those people with have anal sensation and motor function recover significantly more function than those who do not.

    Note: I want to add the following points:
    1. The myth of "complete" spinal cord injury. The word "complete" spinal cord injury is a misleading term and should be applied only if there is confirmed transection of the spinal cord. Having no voluntary movement or sensation below the injury site does not mean that there is complete loss of all connections across the injury site. Many people, for example, still retain some ability to inhibit or increase spasms or spasticity in their legs even though they cannot voluntarily move them. For example, I have seen many people show increased spasticity in their legs when they are nervous or have been told a funny joke. A majority of people who are so-called "complete" spinal cord injured will recover at least one and sometimes 2 or more segmental levels of motor and sensory function, especially if they received methylprednisolone.
    2. Spasms do not necessarily mean voluntary motor activity. Spasms of course mean that there are functional neurons and activity in your spinal cord. If you don't have voluntary control of the spasms, they may be spontaneous or arise from sensory stimulation from below the injury site. However, some people can control their spasms to some extent. Your question illustrates the problem with the definition of complete injury. It is much better to describe the phenomenon than to apply the definitions of complete and incomplete.
    3. A vast majority of people do not have transected spinal cords. I have heard many people claim that they have been told by their doctors that they have "transected spinal cords". But, on closer questioning, it usually turns out to be an offhand remark by the doctor based on an MRI or CT scan. Please note that both MRI and CT scans may give the impression of a transected cord but the cord may not be transected. The only really confirmed cases of spinal cord transection that I know about are ones that have been observed in surgery. These are very rare.


    Wise.
    Last edited by Wise Young; 01-26-2007 at 02:35 AM.

  7. #7
    I am a T11/T12 and supposively "complete", until recently I gained back sensation in my anal region, after six years. Hello anus!

  8. #8
    Senior Member lunasicc42's Avatar
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    "hello anus! " lol
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  9. #9
    Quote Originally Posted by Tiger Racing View Post
    That's just dumb. It makes no sense to say that someone who has broken their neck, but can still use their arms and hands is "complete" just because they can't feel their butt.

    C.
    asia scale is a joke!

  10. #10

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