A patient with a C7 spinal cord injury and intact anal sensation should be classified as which ASIA impairment scale level?

• A. Grade D
• B. Grade B
• C. Grade A
• D. Grade C

Answer: (B)

ASIA impairment level is determined by whether sensory and motor function is preserved below the neurological level, including sacral S4-S5. Intact anal sensation means sacral sensory function is preserved, so the injury is not complete (which would disrupt sacral function). If there is sensory preservation below the level but no information about motor function, this fits the sensory incomplete category, labeled AIS B. If motor function below the level were present and sufficiently strong, the classification could shift to C or D depending on how many key muscles below the level have strength ≥3, but with only the sensory detail given, the best match is sensory incomplete.