Incomplete question

[mom23]

My daughter has a L1 injury, 5 years ago. After initial injury she was Scored Asia A. She was discharged with Asia B, one or two years later still Asia B, All because of no anal contracting. However she can wear Afo's and walk on treadmill while hanging onto bar. Or short distance with crutches. What does Asia B really mean? I thought her Dr told us that likely not get anymore back. I know I shouldn't get hung up on this Asia score, but it bugs me as I would think her muscles are more like Asia C.

[mom23]

Or is Asia B still a complete??

[SCI-Nurse]

ASIA B is not based on anal sphincter contraction, but on SENSATION at the anal sphincter. Does she have this? If she has that, and also has the amount of muscle return you describe, she is probably an ASIA C or D. Here are the current standards:

http://www.asia-spinalinjury.org/pub...m_Sheet_r4.pdf

ASIA A is considered complete. B, C, D and E are incomplete.

(KLD)

[mom23]

Thanks nurse. Yes she has sensation as of last exam. Not sure when that was, probably 2 years post.

[scitotalfitness]

As Nurse said, the ASIA B classification does come from sensation at the lowest level of the spinal cord and C would indicate volitional control.

L1 is a tricky level though because the spinal cord ends around L2. The spinal cord is an extension of the brain, so upper motor neuron. The nerves leave the cord, and then are know as lower motor neuron. With injuries affecting more lower motor neurons are known as cauda equina syndrome, and this would look different than an upper motor neuron ASIA score. With your description of her strength, it sounds like she may have a cauda equina presentation.

Bowel and bladder management is different for this type of injury due to the absent reflexes and that may be helpful in determining if your daughter has more of an upper or lower motor neuron injury. SCI Nurse, do you agree? You may be able to elaborate more.