International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI)
The standard examination for classifying the level and completeness of a spinal cord injury.
By Claire White
- Clinician-administered by a trained examiner; 15 to 30 minutes.
- Motor score 0 to 100; light-touch and pin-prick sensory scores each 0 to 112 (total 224).
- ASIA Impairment Scale (AIS) grade: A (complete) through E (normal).
- Defines the neurological level of injury (NLI).
What it measures
The ISNCSCI tests 10 key muscle groups bilaterally (motor score) and 28 dermatomes for light touch and pin-prick sensation bilaterally (sensory scores). These scores define the neurological level of injury, the most caudal segment with normal motor and sensory function on both sides. The ASIA Impairment Scale then grades completeness: A (no motor/sensory in sacral segments S4–S5) through E (normal).
What the result tells you
The NLI, AIS grade, and numeric scores together characterise the injury. AIS grade is the single most important prognostic indicator. Motor and sensory scores are used in clinical trials to measure recovery or intervention effects. The ISNCSCI is the required classification standard for SCI research and clinical practice worldwide.
Used for
Evidence, psychometrics and provenance
Psychometrics
Inter-rater agreement on a 0 to 1 scale. Higher is better.
References
This assessment uses a validated instrument and is reference information, not a diagnosis.