A patient with a C4 SCI has intact sensation at C4 but absent at C5. Motor function is grade 5 at C4 and grade 0 at C5. What is the sensory level?

A patient with a C4 SCI has intact sensation at C4 but absent at C5. Motor function is grade 5 at C4 and grade 0 at C5. What is the sensory level?

• A. C4
• B. C5
• C. C6
• D. Cannot be determined

Answer: (A)

In spinal cord injury assessment, the sensory level is the most caudal (lowest) segment with normal sensation on both sides, as determined by sensory testing (light touch and pinprick). Here, sensation is intact at the C4 level but absent at C5, so the last normal segment is C4. Therefore, the sensory level is C4. Note that motor findings can dissociate from sensory levels—this case has normal motor at C4 and absent motor at C5, but the question is about sensation, which follows the most caudal intact sensory segment, not the motor level.

In spinal cord injury assessment, the sensory level is the most caudal (lowest) segment with normal sensation on both sides, as determined by sensory testing (light touch and pinprick). Here, sensation is intact at the C4 level but absent at C5, so the last normal segment is C4. Therefore, the sensory level is C4. Note that motor findings can dissociate from sensory levels—this case has normal motor at C4 and absent motor at C5, but the question is about sensation, which follows the most caudal intact sensory segment, not the motor level.