{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:51:08Z","timestamp":1775148668299,"version":"3.50.1"},"reference-count":40,"publisher":"American Spinal Injury Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"\n Background:<\/jats:title>\n In the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), two approaches for determining motor levels (MLs) in not clinically testable myotomes (C2-C4, T2-L1, S2-S5) are described: one where the motor level follows the sensory level (MFSL) and another deriving motor function from sensory function (MFSF). Their results differ when (1) all key muscles of an upper (or upper and lower) extremity are scored as intact, (2) sensation is not normal in key muscle segments, and (3) a contiguous region of normal sensation starts at T2 (or S2).<\/jats:p>\n <\/jats:sec>\n \n Objectives:<\/jats:title>\n This work aims to characterize these cases and to discuss explanations.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We analyzed 1330 early and late ISNCSCI assessments of 665 individuals from EMSCI.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Forty-nine (3.6% of all 2660 MLs) MFSL (63.3% T1, 36.7% S1) and MFSF MLs from 34 individuals differed without consequences on ASIA Impairment Scale (AIS) grades (4 AIS A, 1 AIS B, 29 AIS D). In 16 AIS D cases, all testable motor functions were intact, with a mean Spinal Cord Independence Measure (SCIM) total score of 95.67 \u00b1 3.51 in 3 individuals with MFSL-ML T1 and 100 in 5 individuals with MFSL-ML S1. The MFSF-MLs are on average 9.63 \u00b1 7.50 (T1: 12.16 \u00b1 8.43; S1: 5.28 \u00b1 1.36) segments caudal to the sensory level (SL).<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n We identified and characterized rare cases with an unusual sensory impairment pattern, which could be explained by an isolated damage of afferent spinal tracts or the presence of non-SCI conditions. Further investigations of these case are necessary for a more conclusive ML definition.<\/jats:p>\n <\/jats:sec>","DOI":"10.46292\/sci24-00094","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T17:05:21Z","timestamp":1755882321000},"page":"37-47","source":"Crossref","is-referenced-by-count":0,"title":["Clarifications of the Motor Level Definition in the International Standards for Neurological Classification of Spinal Cord Injury in Not Clinically Testable Myotomes"],"prefix":"10.46292","volume":"31","author":[{"given":"Christian","family":"Schuld","sequence":"first","affiliation":[{"name":"Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany"},{"name":"Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Franz","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany"},{"name":"Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany"},{"name":"AUVA Rehabilitation Center Wei\u00dfer Hof, Department for Spinal Cord Injury, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Heutehaus","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany"},{"name":"Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen","family":"Walden","sequence":"additional","affiliation":[{"name":"Praxis Spinal Cord Institute, Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianna","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Guest","sequence":"additional","affiliation":[{"name":"The Miami Project to Cure Paralysis, Miller School of Medicine, Miami, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fin","family":"Biering-S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Kirshblum","sequence":"additional","affiliation":[{"name":"Kessler Institute for Rehabilitation, Department of Physical Medicine and Rehabilitation, West Orange, New Jersey"},{"name":"Rutgers New Jersey Medical School, Newark, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruediger","family":"Rupp","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany"},{"name":"Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"25425","reference":[{"issue":"2","key":"b1","series-title":"Top Spinal Cord Inj Rehabil","first-page":"1","article-title":"International Standards for Neurological Classification of Spinal Cord Injury: Revised 2019","volume":"27","author":"Rupp R","year":"2021","unstructured":"Rupp R, Biering-S\u00f8rensen F, Burns SP, et al. International Standards for Neurological Classification of Spinal Cord Injury: Revised 2019. Top Spinal Cord Inj Rehabil. 2021;27(2):1-22. doi:https:\/\/doi.org\/10.46292\/sci2702-1."},{"key":"b2","series-title":"Spinal Cord","article-title":"Theoretical and practical training improves knowledge of the examination guidelines of the International Standards for Neurological Classification of Spinal Cord Injury","author":"Franz S","year":"2020","unstructured":"Franz S, Heutehaus L, Weinand S, Weidner N, Rupp R, Schuld C. Theoretical and practical training improves knowledge of the examination guidelines of the International Standards for Neurological Classification of Spinal Cord Injury. Spinal Cord. Nov 17 2020;doi:10.1038\/s41393-020-00578-1."},{"issue":"4","key":"b3","series-title":"Spinal Cord","first-page":"282","article-title":"Effect of formal training in scaling, scoring and classification of the International Standards for Neurological Classification of Spinal Cord Injury","volume":"51","author":"Schuld C","year":"2013","unstructured":"Schuld C, Wiese J, Franz S, et al. Effect of formal training in scaling, scoring and classification of the International Standards for Neurological Classification of Spinal Cord Injury. Spinal Cord. 2013;51(4):282-288. doi:10.1038\/sc.2012.149."},{"issue":"11","key":"b4","series-title":"Spinal Cord","first-page":"994","article-title":"Achieving assessor accuracy on the International Standards for Neurological Classification of Spinal Cord Injury","volume":"55","author":"Armstrong AJ","year":"2017","unstructured":"Armstrong AJ, Clark JM, Ho DT, et al. Achieving assessor accuracy on the International Standards for Neurological Classification of Spinal Cord Injury. Spinal Cord. 2017;55(11):994-1001. doi:10.1038\/sc.2017.67."},{"issue":"5","key":"b5","series-title":"J Spinal Cord Med","first-page":"504","article-title":"International Standards for neurological Classification of Spinal Cord Injury: Impact of the revised worksheet (revision 02\/13) on classification performance","volume":"39","author":"Schuld C","year":"2016","unstructured":"Schuld C, Franz S, Bruggemann K, et al. International Standards for neurological Classification of Spinal Cord Injury: Impact of the revised worksheet (revision 02\/13) on classification performance. J Spinal Cord Med. 2016;39(5):504-512. doi:10.1080\/10790268.2016.1180831."},{"issue":"6","key":"b6","series-title":"J Spinal Cord Med","first-page":"535","article-title":"International Standards for Neurological Classification of Spinal Cord Injury (revised 2011)","volume":"34","author":"Kirshblum SC","year":"2011","unstructured":"Kirshblum SC, Burns SP, Biering-Sorensen F, et al. International Standards for Neurological Classification of Spinal Cord Injury (revised 2011). J Spinal Cord Med. 2011;34(6):535-546. doi:10.1179\/204577211X13207446293695."},{"issue":"3","key":"b7","series-title":"J Neurotrauma","first-page":"453","article-title":"Computer implementation of the International Standards for Neurological Classification of Spinal Cord Injury for consistent and efficient derivation of its subscores including handling of data from not testable segments","volume":"29","author":"Schuld C","year":"2012","unstructured":"Schuld C, Wiese J, Hug A, et al. Computer implementation of the International Standards for Neurological Classification of Spinal Cord Injury for consistent and efficient derivation of its subscores including handling of data from not testable segments. J Neurotrauma. 2012;29(3):453-461. doi:10.1089\/neu.2011.2085."},{"key":"b8","series-title":"Reference Manual for the International Standards for Neurological Classification of Spinal Cord Injury","author":"American Spinal Injury Association","year":"2003","unstructured":"American Spinal Injury Association. Reference Manual for the International Standards for Neurological Classification of Spinal Cord Injury. Chicago, IL: ASIA; 2003."},{"issue":"4","key":"b9","series-title":"J Spinal Cord Med","first-page":"346","article-title":"2009 review and revisions of the International Standards for the Neurological Classification of Spinal Cord Injury","volume":"33","author":"Waring WP","year":"2010","unstructured":"Waring WP, Biering-Sorensen F, Burns S, et al. 2009 review and revisions of the International Standards for the Neurological Classification of Spinal Cord Injury. J Spinal Cord Med. 2010;33(4):346-352."},{"key":"b10","series-title":"Front Neurol","first-page":"677888","article-title":"Revisiting the examination of sharp\/dull discrimination as clinical measure of spinothalamic tract integrity","volume":"12","author":"Heutehaus L","year":"2021;","unstructured":"Heutehaus L, Schuld C, Solinas D, et al. Revisiting the examination of sharp\/dull discrimination as clinical measure of spinothalamic tract integrity. Front Neurol. 2021;12:677888. doi:10.3389\/fneur.2021.677888."},{"issue":"3","key":"b11","series-title":"Spinal Cord","first-page":"197","article-title":"Development and validation of a computerized algorithm for International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI)","volume":"54","author":"Walden K","year":"2016","unstructured":"Walden K, Belanger LM, Biering-Sorensen F, et al. Development and validation of a computerized algorithm for International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Spinal Cord. 2016;54(3):197-203. doi:10.1038\/sc.2015.137."},{"issue":"1","key":"b12","series-title":"Spinal Cord","first-page":"37","article-title":"Implementation of multilingual support of the European Multicenter Study about Spinal Cord Injury (EMSCI) ISNCSCI calculator","volume":"60","author":"Schuld C","year":"2022","unstructured":"Schuld C, Franz S, Schweidler J, et al. Implementation of multilingual support of the European Multicenter Study about Spinal Cord Injury (EMSCI) ISNCSCI calculator. Spinal Cord. 2022;60(1):37-44. doi:10.1038\/s41393-021-00672-y."},{"issue":"1","key":"b13","series-title":"Spinal Cord","first-page":"1","article-title":"Providing the clinical basis for new interventional therapies: Refined diagnosis and assessment of recovery after spinal cord injury","volume":"42","author":"Curt A","year":"2004","unstructured":"Curt A, Schwab ME, Dietz V. Providing the clinical basis for new interventional therapies: Refined diagnosis and assessment of recovery after spinal cord injury. Spinal Cord. 2004;42(1):1-6. doi:10.1038\/sj.sc.3101558."},{"issue":"1","key":"b14","series-title":"BMC Med","first-page":"225","article-title":"International surveillance study in acute spinal cord injury confirms viability of multinational clinical trials","volume":"20","author":"Bourguignon L","year":"2022","unstructured":"Bourguignon L, Tong B, Geisler F, et al. International surveillance study in acute spinal cord injury confirms viability of multinational clinical trials. BMC Med. 2022;20(1):225. doi:10.1186\/s12916-022-02395-0."},{"issue":"24","key":"b15","series-title":"Disabil Rehabil","first-page":"1926","article-title":"The Spinal Cord Independence Measure (SCIM) version III:: Reliability and validity in a multi-center international study","volume":"29","author":"Itzkovich M","year":"2007","unstructured":"Itzkovich M, Gelernter I, Biering-Sorensen F, et al. The Spinal Cord Independence Measure (SCIM) version III:: Reliability and validity in a multi-center international study. Disabil Rehabil. 2007;29(24):1926-1933. doi:10.1080\/09638280601046302."},{"issue":"5","key":"b16","series-title":"J Spinal Cord Med","first-page":"538","article-title":"International Standards for Neurological Classification of Spinal Cord Injury: Training effect on accurate classification","volume":"31","author":"Chafetz RS","year":"2008","unstructured":"Chafetz RS, Vogel LC, Betz RR, Gaughan JP, Mulcahey MJ. International Standards for Neurological Classification of Spinal Cord Injury: Training effect on accurate classification. J Spinal Cord Med. 2008;31(5):538-542."},{"issue":"12","key":"b17","series-title":"Spinal Cord","first-page":"919","article-title":"Feasibility of using training cases from International Spinal Cord Injury Core Data Set for testing of International Standards for Neurological Classification of Spinal Cord Injury items","volume":"52","author":"Liu N","year":"2014","unstructured":"Liu N, Hu ZW, Zhou MW, Biering-Sorensen F. Feasibility of using training cases from International Spinal Cord Injury Core Data Set for testing of International Standards for Neurological Classification of Spinal Cord Injury items. Spinal Cord. 2014;52(12):919-922. doi:10.1038\/sc.2014.141."},{"issue":"4","key":"b18","series-title":"Spinal Cord","first-page":"324","article-title":"International Standards for Neurological Classification of Spinal Cord Injury: Classification skills of clinicians versus computational algorithms","volume":"53","author":"Schuld C","year":"2015","unstructured":"Schuld C, Franz S, van Hedel HJ, et al. International Standards for Neurological Classification of Spinal Cord Injury: Classification skills of clinicians versus computational algorithms. Spinal Cord. 2015;53(4):324-331. doi:10.1038\/sc.2014.221."},{"issue":"1","key":"b19","series-title":"Spinal Cord","first-page":"18","article-title":"A taxonomy for consistent handling of conditions not related to the spinal cord injury (SCI) in the International Standards for Neurological Classification of SCI (ISNCSCI)","volume":"60","author":"Rupp R","year":"2022","unstructured":"Rupp R, Schuld C, Biering-S\u00f8rensen F, Walden K, Rodriguez G, Kirshblum S. A taxonomy for consistent handling of conditions not related to the spinal cord injury (SCI) in the International Standards for Neurological Classification of SCI (ISNCSCI). Spinal Cord. 2022;60(1):18-29. doi:10.1038\/s41393-021-00646-0."},{"issue":"2","key":"b20","series-title":"J Spinal Cord Med","first-page":"120","article-title":"International Standards for Neurological Classification of Spinal Cord Injury: Cases with classification challenges","volume":"37","author":"Kirshblum SC","year":"2014","unstructured":"Kirshblum SC, Biering-Sorensen F, Betz R, et al. International Standards for Neurological Classification of Spinal Cord Injury: Cases with classification challenges. J Spinal Cord Med. 2014;37(2):120-127. doi:10.1179\/2045772314Y.0000000196."},{"issue":"2","key":"b1","series-title":"Top Spinal Cord Inj Rehabil","first-page":"1","article-title":"International Standards for Neurological Classification of Spinal Cord Injury: Revised 2019","volume":"27","author":"Rupp R","year":"2021","unstructured":"Rupp R, Biering-S\u00f8rensen F, Burns SP, et al. International Standards for Neurological Classification of Spinal Cord Injury: Revised 2019. Top Spinal Cord Inj Rehabil. 2021;27(2):1-22. doi:https:\/\/doi.org\/10.46292\/sci2702-1."},{"key":"b2","series-title":"Spinal Cord","article-title":"Theoretical and practical training improves knowledge of the examination guidelines of the International Standards for Neurological Classification of Spinal Cord Injury","author":"Franz S","year":"2020","unstructured":"Franz S, Heutehaus L, Weinand S, Weidner N, Rupp R, Schuld C. Theoretical and practical training improves knowledge of the examination guidelines of the International Standards for Neurological Classification of Spinal Cord Injury. Spinal Cord. Nov 17 2020;doi:10.1038\/s41393-020-00578-1."},{"issue":"4","key":"b3","series-title":"Spinal Cord","first-page":"282","article-title":"Effect of formal training in scaling, scoring and classification of the International Standards for Neurological Classification of Spinal Cord Injury","volume":"51","author":"Schuld C","year":"2013","unstructured":"Schuld C, Wiese J, Franz S, et al. Effect of formal training in scaling, scoring and classification of the International Standards for Neurological Classification of Spinal Cord Injury. Spinal Cord. 2013;51(4):282-288. doi:10.1038\/sc.2012.149."},{"issue":"11","key":"b4","series-title":"Spinal Cord","first-page":"994","article-title":"Achieving assessor accuracy on the International Standards for Neurological Classification of Spinal Cord Injury","volume":"55","author":"Armstrong AJ","year":"2017","unstructured":"Armstrong AJ, Clark JM, Ho DT, et al. Achieving assessor accuracy on the International Standards for Neurological Classification of Spinal Cord Injury. Spinal Cord. 2017;55(11):994-1001. doi:10.1038\/sc.2017.67."},{"issue":"5","key":"b5","series-title":"J Spinal Cord Med","first-page":"504","article-title":"International Standards for neurological Classification of Spinal Cord Injury: Impact of the revised worksheet (revision 02\/13) on classification performance","volume":"39","author":"Schuld C","year":"2016","unstructured":"Schuld C, Franz S, Bruggemann K, et al. International Standards for neurological Classification of Spinal Cord Injury: Impact of the revised worksheet (revision 02\/13) on classification performance. J Spinal Cord Med. 2016;39(5):504-512. doi:10.1080\/10790268.2016.1180831."},{"issue":"6","key":"b6","series-title":"J Spinal Cord Med","first-page":"535","article-title":"International Standards for Neurological Classification of Spinal Cord Injury (revised 2011)","volume":"34","author":"Kirshblum SC","year":"2011","unstructured":"Kirshblum SC, Burns SP, Biering-Sorensen F, et al. International Standards for Neurological Classification of Spinal Cord Injury (revised 2011). J Spinal Cord Med. 2011;34(6):535-546. doi:10.1179\/204577211X13207446293695."},{"issue":"3","key":"b7","series-title":"J Neurotrauma","first-page":"453","article-title":"Computer implementation of the International Standards for Neurological Classification of Spinal Cord Injury for consistent and efficient derivation of its subscores including handling of data from not testable segments","volume":"29","author":"Schuld C","year":"2012","unstructured":"Schuld C, Wiese J, Hug A, et al. Computer implementation of the International Standards for Neurological Classification of Spinal Cord Injury for consistent and efficient derivation of its subscores including handling of data from not testable segments. J Neurotrauma. 2012;29(3):453-461. doi:10.1089\/neu.2011.2085."},{"key":"b8","series-title":"Reference Manual for the International Standards for Neurological Classification of Spinal Cord Injury","author":"American Spinal Injury Association","year":"2003","unstructured":"American Spinal Injury Association. Reference Manual for the International Standards for Neurological Classification of Spinal Cord Injury. Chicago, IL: ASIA; 2003."},{"issue":"4","key":"b9","series-title":"J Spinal Cord Med","first-page":"346","article-title":"2009 review and revisions of the International Standards for the Neurological Classification of Spinal Cord Injury","volume":"33","author":"Waring WP","year":"2010","unstructured":"Waring WP, Biering-Sorensen F, Burns S, et al. 2009 review and revisions of the International Standards for the Neurological Classification of Spinal Cord Injury. J Spinal Cord Med. 2010;33(4):346-352."},{"key":"b10","series-title":"Front Neurol","first-page":"677888","article-title":"Revisiting the examination of sharp\/dull discrimination as clinical measure of spinothalamic tract integrity","volume":"12","author":"Heutehaus L","year":"2021;","unstructured":"Heutehaus L, Schuld C, Solinas D, et al. Revisiting the examination of sharp\/dull discrimination as clinical measure of spinothalamic tract integrity. Front Neurol. 2021;12:677888. doi:10.3389\/fneur.2021.677888."},{"issue":"3","key":"b11","series-title":"Spinal Cord","first-page":"197","article-title":"Development and validation of a computerized algorithm for International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI)","volume":"54","author":"Walden K","year":"2016","unstructured":"Walden K, Belanger LM, Biering-Sorensen F, et al. Development and validation of a computerized algorithm for International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Spinal Cord. 2016;54(3):197-203. doi:10.1038\/sc.2015.137."},{"issue":"1","key":"b12","series-title":"Spinal Cord","first-page":"37","article-title":"Implementation of multilingual support of the European Multicenter Study about Spinal Cord Injury (EMSCI) ISNCSCI calculator","volume":"60","author":"Schuld C","year":"2022","unstructured":"Schuld C, Franz S, Schweidler J, et al. Implementation of multilingual support of the European Multicenter Study about Spinal Cord Injury (EMSCI) ISNCSCI calculator. Spinal Cord. 2022;60(1):37-44. doi:10.1038\/s41393-021-00672-y."},{"issue":"1","key":"b13","series-title":"Spinal Cord","first-page":"1","article-title":"Providing the clinical basis for new interventional therapies: Refined diagnosis and assessment of recovery after spinal cord injury","volume":"42","author":"Curt A","year":"2004","unstructured":"Curt A, Schwab ME, Dietz V. Providing the clinical basis for new interventional therapies: Refined diagnosis and assessment of recovery after spinal cord injury. Spinal Cord. 2004;42(1):1-6. doi:10.1038\/sj.sc.3101558."},{"issue":"1","key":"b14","series-title":"BMC Med","first-page":"225","article-title":"International surveillance study in acute spinal cord injury confirms viability of multinational clinical trials","volume":"20","author":"Bourguignon L","year":"2022","unstructured":"Bourguignon L, Tong B, Geisler F, et al. International surveillance study in acute spinal cord injury confirms viability of multinational clinical trials. BMC Med. 2022;20(1):225. doi:10.1186\/s12916-022-02395-0."},{"issue":"24","key":"b15","series-title":"Disabil Rehabil","first-page":"1926","article-title":"The Spinal Cord Independence Measure (SCIM) version III:: Reliability and validity in a multi-center international study","volume":"29","author":"Itzkovich M","year":"2007","unstructured":"Itzkovich M, Gelernter I, Biering-Sorensen F, et al. The Spinal Cord Independence Measure (SCIM) version III:: Reliability and validity in a multi-center international study. Disabil Rehabil. 2007;29(24):1926-1933. doi:10.1080\/09638280601046302."},{"issue":"5","key":"b16","series-title":"J Spinal Cord Med","first-page":"538","article-title":"International Standards for Neurological Classification of Spinal Cord Injury: Training effect on accurate classification","volume":"31","author":"Chafetz RS","year":"2008","unstructured":"Chafetz RS, Vogel LC, Betz RR, Gaughan JP, Mulcahey MJ. International Standards for Neurological Classification of Spinal Cord Injury: Training effect on accurate classification. J Spinal Cord Med. 2008;31(5):538-542."},{"issue":"12","key":"b17","series-title":"Spinal Cord","first-page":"919","article-title":"Feasibility of using training cases from International Spinal Cord Injury Core Data Set for testing of International Standards for Neurological Classification of Spinal Cord Injury items","volume":"52","author":"Liu N","year":"2014","unstructured":"Liu N, Hu ZW, Zhou MW, Biering-Sorensen F. Feasibility of using training cases from International Spinal Cord Injury Core Data Set for testing of International Standards for Neurological Classification of Spinal Cord Injury items. Spinal Cord. 2014;52(12):919-922. doi:10.1038\/sc.2014.141."},{"issue":"4","key":"b18","series-title":"Spinal Cord","first-page":"324","article-title":"International Standards for Neurological Classification of Spinal Cord Injury: Classification skills of clinicians versus computational algorithms","volume":"53","author":"Schuld C","year":"2015","unstructured":"Schuld C, Franz S, van Hedel HJ, et al. International Standards for Neurological Classification of Spinal Cord Injury: Classification skills of clinicians versus computational algorithms. Spinal Cord. 2015;53(4):324-331. doi:10.1038\/sc.2014.221."},{"issue":"1","key":"b19","series-title":"Spinal Cord","first-page":"18","article-title":"A taxonomy for consistent handling of conditions not related to the spinal cord injury (SCI) in the International Standards for Neurological Classification of SCI (ISNCSCI)","volume":"60","author":"Rupp R","year":"2022","unstructured":"Rupp R, Schuld C, Biering-S\u00f8rensen F, Walden K, Rodriguez G, Kirshblum S. A taxonomy for consistent handling of conditions not related to the spinal cord injury (SCI) in the International Standards for Neurological Classification of SCI (ISNCSCI). Spinal Cord. 2022;60(1):18-29. doi:10.1038\/s41393-021-00646-0."},{"issue":"2","key":"b20","series-title":"J Spinal Cord Med","first-page":"120","article-title":"International Standards for Neurological Classification of Spinal Cord Injury: Cases with classification challenges","volume":"37","author":"Kirshblum SC","year":"2014","unstructured":"Kirshblum SC, Biering-Sorensen F, Betz R, et al. International Standards for Neurological Classification of Spinal Cord Injury: Cases with classification challenges. J Spinal Cord Med. 2014;37(2):120-127. doi:10.1179\/2045772314Y.0000000196."}],"container-title":["Topics in Spinal Cord Injury Rehabilitation"],"original-title":[],"link":[{"URL":"https:\/\/tscir.kglmeridian.com\/view\/journals\/tscr\/31\/3\/article-p37.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/tscir\/article-pdf\/31\/3\/37\/3550894\/i1945-5763-31-3-37.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/tscir.kglmeridian.com\/downloadpdf\/journals\/tscr\/31\/3\/article-p37.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/tscir.kglmeridian.com\/downloadpdf\/journals\/tscr\/31\/3\/article-p37.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T15:50:47Z","timestamp":1775145047000},"score":1,"resource":{"primary":{"URL":"https:\/\/tscir.kglmeridian.com\/view\/journals\/tscr\/31\/3\/article-p37.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":40,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.46292\/sci24-00094","relation":{},"ISSN":["1082-0744","1945-5763"],"issn-type":[{"value":"1082-0744","type":"print"},{"value":"1945-5763","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}