A new scale for the clinical assessment of spinal cord function

The systems currently used for grading the severity of neurologic injuries have serious limitations. The authors have developed a neurologic grading system to assess spinal cord function. This is a new, functionally oriented scale which can be used at the bedside and requires no special tests other than those done in a routine clinical neurological examination. This scale includes assessment of motor and sensory function, rectal tone, and bladder control. A major advantage of this scale is that motor function is assessed on a functional rating system. To evaluate the usefulness of this scheme, patients who have been previously entered into a prospective study on the surgical treatment of burst fractures were re-evaluated. A significant number of patients under our new reclassification system were noted to have had significant improvement which had been overlooked using the Frankel Grade system. The authors conclude that their new spinal cord assessment technique has many advantages and suggest that it be used by spinal cord injury centers.