A 45-year-old woman is assessed after a road traffic accident and found to have an ASIA impairment score of B. Which of the following accurately describes this classification?

• A Motor and sensory function preserved below the injury level; no useful motor function below S3
• B Motor function is preserved below the neurological level with at least half of key muscles graded 3 or more
• C Sensory but NOT motor function is preserved below the neurological level including S4-S5 sacral segments ✓
• D Complete injury with no motor or sensory function preserved in sacral segments S4-S5

Explanation

The ASIA Impairment Scale classifies spinal cord injuries: A = Complete (no motor or sensory below S4-S5); B = Incomplete — sensory but NOT motor preserved below the neurological level including S4-S5 (sacral sparing); C = Incomplete — motor preserved below but <50% of key muscles have grade ≥3; D = Incomplete — motor preserved below and ≥50% of key muscles have grade ≥3; E = Normal. ASIA B indicates sensory sparing without functional motor activity, which has important prognostic implications — ~50% of ASIA B patients progress to ASIA C or D with treatment.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.