SCIs are not always immediately recognizable. The following injuries should be assessed for possible damage to the spinal cord1:
If any of these injuries occur together with any of the symptoms mentioned above (acute head, neck, or back pain; decline of feeling in the extremities; loss of control over part of the body; urinary or bowel problems; walking difficulty; pain or pressure bands in the chest area; difficulty breathing; head or spine lumps), then SCI may be implicated.2
A person suspected of having an SCI must be carefully transported—to prevent further injury the spine should be kept immobile—to an emergency room or trauma center. A doctor will question the person to determine the nature of the accident, and the medical staff may test the patient for sensory function and movement. If the injured person complains of neck pain, is not fully awake, or has obvious signs of weakness or neurological injury, diagnostic tests will be performed.
These tests may include3:
On about the third day after the injury, doctors give patients a complete neurological examination to diagnose the severity of the injury and predict the likely extent of recovery. This involves testing the patient's muscle strength and ability to sense light touch and a pinprick. Doctors use the standard ASIA (American Spinal Injury Association) Impairment Scale for this diagnosis. X-rays, MRIs, or more advanced imaging techniques are also used to visualize the entire length of the spine.
The ASIA Impairment Scale has five classification levels, ranging from complete loss of neural function in the affected area to completely normal4:
To illustrate, a person classified as C-level on the ASIA scale functions better than a person at the B level. Time was, a patient might have been labeled a C4 quadriplegic. Today, however, using the ASIA scale, the classification might be C4 ASIA A tetraplegic. Regarding muscle-strength grades, zero is the lowest, corresponding to complete absence of muscle movement. Five is the highest, representing full, normal strength.5,6
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