(2011 )

International Standards for Neurological Classification of Spinal Cord

Injuy
American Spinal Injury Association( ASIA)
International Spinal Cord Society( ISCOS)
[]

ISNCSCI
ASIA
ISNCSCI
[13]
InSTeP [15]
ISNCSCI ASIA e
e-InSTeP 6
[15]
AIS
WeeSTeP e-
ASTeP ISNCSCI

1 4 5
20-21 InSTeP [15]
2 C5 T2-L1

27
3ZPP
32
4 AIS B C
AIS C D AIS B C AIS
C D NLI 31
5) AIS 2003
[13]
AIS B C

1DAP

2 C2 C1

3 S4-5

DAP

4 AIS A ZPP InSTeP

ZPP
ISNCSCI ZPP NL[13] ZPP
C5 C6 C7
NLI C5 ZPP C7 ZPP 1
NLI C7 2

[15]ISNCSCI

Steven Kirshblum MD

2011 6

()

()

8 C1-C7 C1 C1
C6 C5 C6 C8 C8
C7 T1 C1
12 5 5
5 L1-2

01 2 ISNCSCI

1 1
(SCI)

NLI
ASIA

ASIA

 1
ASIA
www.asia-spinalinjury.org
e-[15]

(tetraplegia quadriplegia)
/

(paraplegia) ()
/

(quadriparesis)(paraparesis)
tetraplegia(paraplegia)
ASIA
(dermatome)
(myotome)
28
/
10 3
[MMT]
MMT 5
NLINLI

R-L-
R-L- NLI
ISNCSCI
SCI

/
56 112 SCI

 25 50
50 SCI
S4-S5 /
S4-5
DAP

S4-S5[14]
ZPP
/ ZPP 4
R-L-R- L-

///
SCI

NT

28 C2 S4-5
2 /
3
0 =
1 =
2 =
NT =

1
/

 10 8
5%[4] 0
/ 1

C2-S4/5 1
C2 1 3
C3
C4
C5
C6
C7
C8
T1
T2
T3 3 IS
IS*
T4 4 ()
T5 5 (T4-T6 )
T6 6 ()
T7 7 (T6-T8 )
T8 8 (T6-T10 )
T9 9 ( T8-T10 )
T10 10 ()
T11 11 (T10-T12 )
T12
L1T12 L2
L2T12
L3
L4
L5 3
S1
S2
S3
S4-5 1 ( 1 )
* T3 2 2
3 3
DAPDAP
S4/5

S4-5 DAP


SCI /

0
1 10 8 ---
2 10 8

10
0
3-5
0

10 C5-T1 L2-S1

6 [1679]
0 =
1 =
2 = ROM
3=
4=
5=
5* =

NT = 50%

ROM 50% 0-5

ROM 50%NT
( )
2

C5 - ()
C6 - ()
C7 - ()
C8 - ()
T1 - ()
L2 - ()
L3 - ()
L4 - ()
L5 ()
S1 - ()

 4 5 0-3 InSTeP
C5 - 90
C6
C7 90 45
C8
T1
L2 90
L3 15
L4 -
L5
S1 //
8
90

VACS2-4

VAC
VAC Valsalva

AIS B C

2 C2
2
4 R-RL-L-
C2 C1 C2 S4-5
INT S5

2 28 56
56 112

 10 3 MMT
5

1
( 2 2) 1 1 (

) 1

1 3
5
2 C7 C6
3 C5 5 C6
5

NT

( MMT 5 ) 5 *
C1C4T2L1 S2S5

1 C4 C5 3 C4
2 C4 C5 3 C5 C5
3 C4 C4

3 C3 C5 3 C3 C4
C4
L2 L1
L2
4 T6 T6
5

#4 T1 3 4 5 T6
T1 T6

5 5 25 50
5 50

100
10 10 50
[10]
NLI

NLI

NLI

NLI
SCI T8
SCI

ASIA AIS
Frankel [381214]

S4-5 DAP
S4-5
S4-5 /
ASIA
A = S4-S5
B = S4-S5

C = **
3 0-2
D = ** NLI
3
E = ISNCSCI
E SCI E
** C D 1
2

AIS B C
AIS B C
C D 3

ZPP
ZPP AIS A
ZPP

C5 C6 C8 ZPP
C8
ZPP

 ZPP ZPP
NLI T4 T6
ZPP T6 ZPP T4ZPP
ZPP NA

AIS

Brown-Sequard
Brown Sequard

Brown Sequard
Brown Sequard Brown Sequard-
[11]

L1 L2
3

1.
Aids to Investigation of Peripheral Nerve Injuries. Medical Research
Council War Memorandum,2nd ed., Revised London, HMSO, 1943.
2.
Alexander MS, Biering-Sorensen F, Bodner D, et al. International
standards to document remaining autonomic function after spinal cord injury.
Spinal Cord. 2009; 47 (1) :36-43

3.
American Spinal Injury Association: International Standards for
Neurological Classification of Spinal Cord Injuryrevised 2000; Atlanta, GA,
Reprinted 2008.
4.
American Spinal Injury Association: Reference manual for the
International Standards for Neurological Classification of Spinal Cord Injury.
Chicago, II: r American Spinal Injury Association; 2003.
5.
Austin, G.M.: The Spinal cord: Basic aspects and Surgical Considerations.
nd
2 ed., P.762. Springfield, IL: Thomas,1972.
6.
Brunnstrom, F,Dennen, M.: Round table on muscle testing. Annual
Conference of American Physical Therapy Association, Federation of Crippled
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7.
Daniel, L, Worthingham, C,: Muscle Testing: Techniques of Manual
Examination . 3rd ed.. Philadelphia Saunders, 1972.
8.
Frankel, H.L. Hancock, DO., Hyslop, G., et al: The value of postural
reduction in the initial management of closed injuries of the spine with
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9.
Lovett, R.W.: The treatment of Infantile Paralysis. 2nd ed.. p. 136
Philadelphia: P. Blakistons Son, 1917.
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improve correlation with functional activities. Arch Phys Med Rehabil
2004;85(11):1804-10
11. Roth EJ, Park T, Pang T, Yarkony GM, Lee MY. Traumatic cervical Brown
Sequard and Brown- Sequard plus syndromes: the spectrum of presentation
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scales for assessing neurological recovery in early management of acute
spinal cord injury. New York: Raven Press, 1982:7.
13. Waring WP 3rd , Biering-Sorenson F, Burns S, et al. 2009 reviews and
revisions of the international standards for the neurological classification of
spinal cord injury. J Spinal Cord Med. 2010; 33(4):346-52
14. Waters, R.L., Adkins,RH., Yakura, JS.: Definition of complete spinal cord
Injury Paraplegia 1991; 9:573-581
15. www.asialearningcenter.com