ASIA Impairment Scale

Select ASIA grade based on clinical examination:

ASIA A - Complete

Complete spinal cord injury: No motor or sensory function preserved in sacral segments S4-S5

Criteria: No sensory or motor function in lowest sacral segments (S4-S5). No anal sensation, no voluntary anal contraction, no deep anal pressure.

ASIA B - Sensory Incomplete

Incomplete: Sensory but NOT motor function preserved below neurological level, including S4-S5 (sacral sparing)

Criteria: Sensory function preserved at S4-S5 (deep anal pressure OR perianal sensation) AND/OR any sensory below neurological level. NO motor function more than 3 levels below motor level.

ASIA C - Motor Incomplete

Incomplete: Motor function preserved below neurological level, and MORE than half of key muscle functions have grade <3

Criteria: Motor function preserved at S4-S5 (voluntary anal contraction) OR motor function more than 3 levels below motor level, with >50% of key muscles below neurological level having grade <3/5.

ASIA D - Motor Incomplete

Incomplete: Motor function preserved below neurological level, and AT LEAST half of key muscle functions have grade ≥3

Criteria: Motor function preserved at S4-S5 (voluntary anal contraction) OR motor function more than 3 levels below motor level, with ≥50% of key muscles below neurological level having grade ≥3/5.

ASIA E - Normal

Normal: Sensory and motor function are normal in all segments, and patient had prior documented deficit

Criteria: All motor and sensory scores are normal (5/5 motor, 2/2 sensory in all testable dermatomes). Reserved for those with documented prior deficits who have recovered.