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Back| Grade | Functional Status |
|---|---|
| A | Complete loss of sensation and muscle function below the level of injury |
| B | Complete loss of motor function below the level of injury, with some preserved sensation including the sacral region |
| C | Some muscle function below the level of injury, but no useful function |
| D | Incomplete muscle function below the level of injury, able to walk with assistance |
| E | Normal sensation and muscle function, with possible pathological reflexes |
Explanation
The Frankel classification provides a rough grading of the severity of spinal cord injury, which is highly practical for assessing spinal cord injuries. However, it has certain limitations in evaluating conus medullaris and cauda equina injuries, lacking criteria for reflex and sphincter function, especially for bladder and rectal sphincter function.
Therefore, many scholars have revised the Frankel classification to create comprehensive standards for different levels of spinal cord or cauda equina injuries, resulting in Standard I for thoracolumbar injuries and Standard II for complete cervical spinal cord injuries.
Each evaluation standard is divided into 5 grades, making the classification of spinal cord injuries more detailed. The advantage is that it allows for the assessment of cervical spinal cord injuries and non-functional lower limbs based on upper limb function.
The American Spinal Injury Association (ASIA) has also revised the Frankel classification.
The ASIA classification is similar to the Frankel classification, still a grading method, but the boundaries between grades are not very clear, so it does not completely overcome the shortcomings of the Frankel classification.
