Sumi Sunny

Research Staff Nurse

Guide:-Dr Deepak Agrawal

Addl. Professor

Department of Neurosurgery

JPNATC AIIMS

A spinal cord injury (SCI) refers to any injury tothe spinal cord that is caused by trauma instead ofdisease

The American Spinal Injury Association (ASIA) iswidely used to document sensory and motorimpairments following SCI

It is based on neurological responses, touch andpinprick sensations tested in each dermatome

To document sensory and motor impairmentsfollowing SCI.

To categorise the patients and give appropriatecare.

To assess nursing role in using ASIA score in SCI

1. MOTOR SCORING

2. SENSORY SCORING

C5 – Elbow flexors

C6 – Wrist extensors

C7 – Elbow extension

C8 – Finger flexors

T1 – 5th digit abduction

L2 – Hip flexion

L3 – Knee extension

L4 – Ankle dorsiflexion

L5 – Long toe extension

S1 – Ankle plantar flexion

1. ASIA-A

2. ASIA-B

3. ASIA-C

4. ASIA-D

5. ASIA-E

Complete SCI

No motor or sensory function is preserved

Nursing Implication:◦ To prognosticate the patient

◦ Appropriate care should be provided to reduce high risk of bed sore

Incomplete SCI

Sensation : Present

Motor function: Absent

Nursing Implication:◦ As sensation is low care should be provided to

prevent bed sore

Incomplete SCI

Sensation: Present (complete)

Motor: Present but grade 3 or less.

Nursing Implication:◦ Nurse motivates patient and their relatives

Incomplete SCI

Sensory: Present (complete) Motor: Present but have a grade more than3.

Nursing Implication:◦ Motivate the patient for physiotherapy and

rehabilitation.

Incomplete SCI

Motor and sensory functions are normal

It implies the presence of a spinal cord injury but without detectable neurological deficits.

TOTAL CASES

ADMISSIONS

OPERATED

DEATH (%)

NON-OPERATED

DEATH (%)

CERVICAL SPINEINJURY

289 178 115 5.6% 174 4.6%

DORSAL SPINE INJURY

112 69 46 - 66 1.7%

LUMBAR SPINE INJURY

119 60 30 - 89 1.7%

TOTAL CASES

COMPLETE INCOMPLETE DEATH (%)

CERVICAL SI 289 116 173 5.9%

DORSAL 112 31 81 0.89%

LUMBAR 119 19 100 0.89%

Manual system of calculating score is:◦ Cumbersome

◦ Time consuming

Computerized system was developed:◦ For easy assessment and entry of motor and

sensory powers for automatic calculation of ASIAScore

Need of this system

Nurses can play a vital role in accurate assessment of ASIA score using computerized software.

This will help in research and follow up of SCI patients.

Document sensory and motor impairments following SCI.

Helps to prognosticate the patient.

Categories the patients and give appropriate care.