SPINAL CORD INJURY

1.Neurological level of SCI

1).Motor level:身體左右兩側同時具有正常運動機能之最低脊髓部位，根據

10條關鍵肌(Key muscles)之肌力而定：

a. Key muscles

上肢 C5 Elbow flexors

C6 Wrist extensors

C7 Elbow extensors

C8 Finger flexors

T1 Finger abductors

下肢 L2 Hip flexors

L3 Knee extensors

L4 Ankle dorsiflexors

L5 Long toe extensors

S1 Ankle plantar flexors

b. Muscle power

0=total paralysis

1=palpable or visible contraction

2=active movement, gravity eliminated

3=active movement, against gravity

4=active movement, against some resistance

5=active movement, against full resistance

c. Motor level之決定，指該部位關鍵肌之肌力在grade 3以上（含grade 3），且上一節關鍵肌之肌力必須是grade 4以上。

2).Sensory level:左右兩側28 dermatome之key sensory point。

a. 測pin-prick與light-touch sensation。

b. 0=absent

1=impaired

2=normal

c. Sensory level之決定:身體左右兩側同時具有正常感覺機能之最低脊髓部位。

ASIA Impairment Scale

A= Complete: No motor or sensory function is preserved in the sacral segments S4-S5

B= Incomplete: Sensory but not motor functions preserved below the neurological level and extends through the sacral segments S4-S5

C= Incomplete: Motor function is preserved below the neurological level, and the majority of key muscles below the neurological level have a muscle grade less than 3

D= Incomplete: Motor function is preserved below the neurological level, and the majority of key muscles below the neurological level have a muscle grade greater than or equal to 3

E= Normal: Motor and sensory function is normal

Frankel classification

A= motor and sensory function complete without any movement or sensation below the lesion

B= motor complete with some sensory sparing

C= motor and sensory incomplete without functional motor recovery

D= functionally useful movement below the lesion

E= motor and sensory recovery to normal function but residual clinical evidence of SCI may still be present

此疾病相關之特殊檢查

Urodynamics尿動力學檢查

尿動力學檢查於本科用於神經性膀胱（neurogenic bladder）的檢查，檢查項目包括：

(1).膀胱壓力圖（cystometry, CMG）：以H2O中等速度灌注膀胱，評估膀胱在

灌注時之容量與壓力的變化情形，瞭解受測膀胱的感覺強度（sensitivity）、

穩定度（stability）、適應性（compliance）及收縮力（contrctility）。

(2).括約肌肌電圖（sphincter electromyography, sphincter EMG）：以表面肌電圖

電極記錄肛門周圍之肌肉活動情形。

(3).尿道壓力圖（urethral pressure profile, UPP）：代表整條尿道內的壓力。在膀

胱靜止狀態時所測得者稱靜態尿道壓力圖（static UPP），在排尿時所測得

稱動態尿道壓力圖（dynamic UPP）。