Complete/ Incomplete ? Wise?

[SCI-Nurse]

Yes, they just amended it last year. anal sensation plus voluntary contraction. It does bring up the thought of well why was it incomplete before- or B. but it is based on research and outcomes etc... They amend or tweka it about every two years based on research and evidenced based outcomes.
CWO

[JacksonsGirl]

Does anyone have the updated, amended version of this chart/ instructions ? I checked the chart that you (SCI NURSE) posted , and it is exactly what I read before..
"Determine whether the injury is Complete or Incomplete.
(i.e. absence or presence of sacral sparing)
If voluntary anal contraction = No AND all S4-5 sensory
scores = 0 AND deep anal pressure = No, then injury is
COMPLETE. Otherwise, injury is incomplete.

My husband would have a sensory score in S4/5 since he has light touch sensation there (according to the chart you posted). I'm sorry I'm not trying to be a pain . I just want to be sure..

[JacksonsGirl]

Again, I really am sorry , but CWO , i don't see where it says that you have to have voluntary anal contraction AND anal sensation to be incomplete. To me it seems pretty cut and dry - if there is a sensory score at all in S4/5 , the individual is incomplete. ? My post just before this was copied from the ASIA chart .
I understand that I could somehow be misunderstanding , but if so, I need to know how so. As I said, the wording that I posted seems pretty cut & dry.
I know, I know. Don't worry about the labels. But.. I intend to become extremely educated on this subject, and I want all of my information and understanding to be absolutely , 100% correct.

[MFlounlacker]

Sorry I really can't help you on this. I will say that I don't have and have never had any sensation at S4-5 since my accident and I am walking. Go figure.

[tweez]

I get what you are saying here.

I have almost perfect sensation/ control in the anal region however practically no control over muscles in the legs 16 months post-injury ...

According to the ASIA classification, you should have a more damaged SC than mine, go figure.

The reasoning behind this classification is that the s4-s5 segments are the last ones (the most distal) therefore a sparing of this region indicated that the spinal cord is only partially damaged... but why wouldn't it be the case if you can walk but can feel/contract your anus? It doesn't really make any sense if you ask me. It also doesn't take into account spasticity, spasms and B&B so you need a bunch of other complicated scales to evaluate these aspects

My personal opinion is that you really shouldn't put too much emphasis on this scale, look more for functional targets. I used to look at the ASIA scale very closely until I realized it really doesn't tell you that much about the functional status of SCI person.

More important is how is your locomotion? your spasticity? Spasms? Is youyr bladder functioning? Cather? Incontinence? Erection present (reflex or brain control), ejaculation present? You bladder working

Asia score can be useful but really don't think its the panacea. I can't wait for them to come up with a scale that is really more reliable for really assessing the damage to your spinal cord in general.

In theory, an ASIA A can be much better off than an ASIA C and even ASIA D. I know some doctors (mainly in Europe) who bother little

Originally Posted by MFlounlacker

Sorry I really can't help you on this. I will say that I don't have and have never had any sensation at S4-5 since my accident and I am walking. Go figure.

[tweez]

... as for the research , there is indeed evidence that someone with anal pinprick sensation and voluntary contraction has bigger chances of reaching independent locomotion but not by much (10-20% more chances) so in my mind it does not appear to be so decisive as to base the whole ASIA scale on it.

[MFlounlacker]

It is a classification and label that really has no purpose at all. Since no one can really tell how injured you have been (unless you have a severed spinal cord) only time will ultimately tell what level you are. What is the point of trying to guess at the point in time when people need the most hope. There are completes who walk and incompletes who can't. That oughta tell you that the classification system isn't quite right.

How many people are disouraged from trying to do more or fall into depression after receiving word that they are complete. That almost happened top me, but I decided that I was different and that I didn't believe them. Well I was right. I appreciate and value all that science is trying to do, so don't get me wrong. I just think that trying to diagnose completeness could be put off til there is more evidence of return or lack there of.

[JacksonsGirl]

You're probably right - Its not going to change anything either way... And i read & hear a lot of stories where someone got the "you're never going to walk again" speech, and ended up walking. It seems that hope is always best no matter how you look at it. I don't know why I was so hell bent on figuring out the score - I guess I just want to understand everything correctly and accurately. Good advice MFlounlacker

[MFlounlacker]

Jacksongirl- There is hope no matter what. Check out some of the threads in exercise and recovery and see what supposed disabled people are doing with their lives.

I was just like you at the beginning. I too was hung up on ASIA this and ASIA that. I totally understand your couriousity. Hang tough. Get it in his head to work hard to get as much return as possible and be stoked with anything.

Encourage him to get on here and see how many of us are still enjoying our lives and whatever return we have gotten back. God bless and keep us posted on his progress.