Injury levels and classification

Classification depends partly on whether sensory or motor function remains in the lowest sacral segments.

Neurological level describes the lowest normally functioning segment identified through examination.

The ISNCSCI examination assesses strength and sensation to classify injury level and completeness. Clinical classification uses preserved function, rather than spinal imaging alone.

Damage to upper or lower motor neuron pathways produces different movement and reflex changes. Upper motor neuron damage can preserve spinal reflexes, whereas lower motor neuron damage interrupts the connection to muscle.