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Severity Classification of Spinal Cord Injury: Frankel Functional Classification and ASIA Classification

Frankel Functional Classification
Level Function
A Complete paralysis
B Partial sensory loss, no motor function
C Partial sensory loss, with non-functional movement
D Partial sensory loss, with functional movement
E Normal sensory and motor function
ASIA Classification
Level Function Spinal Cord Injury Type
A No sensory or motor function in the sacral segments (S4~S5) Complete damage
B Presence of sensory function below the neurological injury level, including the sacral segments (S4~S5), but no motor function Incomplete damage
C Presence of motor function below the neurological injury level, with most key muscles having a strength less than 3 Incomplete damage
D Presence of motor function below the neurological injury level, with most key muscles having a strength greater than or equal to 3 Incomplete damage
E Normal sensory and motor function Normal

Notes

Can be used as an observational index for the natural course of spinal cord injury and for comparison before and after treatment.

Classification is based on the clinical presentation of spinal cord injury, commonly using the International Frankel Classification and the American Spinal Injury Association (ASIA) Classification.

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