Types of Spinal Cord Injuries

Every spinal cord injury is different, and there are four distinct regions of the spinal column that, if damaged, can greatly determine the extent of a person’s mobility and sensation. The four types of spinal cord injuries are cervical, thoracic, lumbar, and sacral. Read below to learn more about each type of SCI.

Cervical

Considered the most severe type of SCI, a cervical spinal cord injury occurs in the first seven vertebrae in the neck: the C1-C7 vertebrae. When a spinal cord injury occurs in this section of the neck, all four limbs are affected, causing quadriplegia. Quadriplegia is defined as any level of paralysis affecting all major extremities. Depending on which vertebrae is injured or broken (C1, C2, C3, etc.), the injured person will have distinctly different sensation and mobility post-injury.

For example, if someone has a C1 injury, they often require the use of a ventilator and are unable to move anything from the neck down. If someone has a C7 injury, which is closer to the bottom of the neck, they will not need a ventilator, and will typically have full arm movement but limited finger control. Here is a list of each section of the cervical spinal column and how a person is affected when each vertebrae is injured:

– C1-C4: With an injury in this area, you can either be fully paralyzed in the arms or have some arm movement. People with a C1 injury will sometimes require a ventilator to breathe. Paralysis is also present in the trunk, legs, feet, hands, and legs; bladder, bowel, and sexual function is also affected. For some people with C1-C4 injuries, the ability to speak may sometimes be impaired or reduced due to the paralysis of the person’s diaphragm. Power wheelchairs and full-time care workers are usually needed for people with this level of injury.

– C5: Someone with this injury will have the ability to move their biceps and shoulders, but will likely not have the ability to move their wrists, hands, trunk, or legs. Assistance with daily living activities is needed, as well as the use of a power chair.

– C6: An injury at this level will usually mean that the individual has wrist movement, as well as bicep and shoulder movement, but paralysis is still present in the hands, trunk, and legs. People who have sustained this level of injury can typically independently move in and out of their bed with the use of adaptive equipment, and they can usually drive their own adaptive vehicle. Because of the wrist movement ability of C6 quadriplegics, many people with this level of injury are able to independently manage their own bladder and bowel care.

– C7: At this level of injury, individuals will have nearly full arm movement, which includes tricep and bicep control. Because of this, many people with a C7 injury have the ability to straighten their arms fully, and they may have some finger extension, as well. Thanks to these abilities, many C7 quadriplegics have the capability of completing most daily living activities independently.

– C8: At this level of injury, most people have full arm movement, as well as the ability to grasp and release objects with their hands. Fine dexterity, however, is not present in people with this level of injury. C8 quadriplegics will also be able to conduct most of their daily living activities independently, although they may need help with difficult tasks. The bladder and bowel control of C8 quadriplegics are similar to, though not much better than, those with C6 and C7 injuries.

Thoracic

The section located in the upper and middle part of the back is called the thoracic spine. This section encompasses 12 vertebrae, making the thoracic region the largest section of the back. When vertebrae are injured anywhere along the thoracic section, many muscles are affected; however, most people with T-level injuries (excluding those with a T-1 injury) have full arm function. Here is an overview of how function is affected depending on the damaged vertebrae’s location in the thoracic spine.

T1: A person with an injury at the T1 level will see some weakness in their hands and fingers, and will likely experience dexterity issues. Chest muscles and everything below the level of injury—i.e., legs, feet, toes—will also be paralyzed.

T2 – T5: People with any spinal cord injury between T-1 and T-5 will see paralysis in their upper chest muscles and back muscles. Additionally, the muscles around the rib cage, the abdominal area, and everything below damaged vertebrae will be paralyzed. Daily activities such as coughing or anything requiring full lung capacity may be difficult with this level of injury.

T6 – T12: An injury between T-6 and T-12 vertebrae will result in paralyzed leg muscles, hip muscles, as well as partially paralyzed abdominal and back muscles. Many people with low T injuries have nearly full abdominal control.

All people with a complete thoracic injury will experience bladder and bowel control loss, and their sexual function will be affected. Walking, however, may be possible with the assistance of braces or crutches.

Lumbar

The lumbar section of the spinal column makes up one of the largest areas of the spinal cord, with some of the biggest vertebrae present. There are five main vertebrae in this section: L1-L5. People with L vertebrae injuries sustain a loss of function in their legs and hips, but have full upper body function.

People with L injuries do not have bowel or bladder control, but they are able to manage their bodily functions independently using specialized equipment such as catheters and suppositories. Some L-level paraplegics may be able to walk using braces or crutches. Here is an explanation of how each lumbar section, if injured, affects the body:

L1 and L2: Hip movements such as bending and flexing is affected.

L3: Knee straightening is limited.

L4: Bending the foot upward is affected.

L5: Extending the toes is affected.

Sacral

Located at the bottom of the spinal column, the sacral area is where you will find the least amount of paralysis after an injury because the sacral section only controls the buttocks and thighs. With all of the nerves in the spinal cord above the injury still fully functional, people with a S-level injury have the ability to take care of themselves independently. Many people with S-level SCIs can even walk. There are five vertebrae in the sacral section of the spinal column. The mobility associated with each damaged vertebrae is listed below:

S1: Paralysis begins at the hips & groin area.

S2: Paralysis will begin from the back of the thighs and will extend downward.

– S3: The middle of the buttox, and downward, will be affected.

– S4: The perineal area will be affected.

– S5: The perineal area will be affected.

The muscles in the sacral region control the sexual organs as well. This means most people with a S-level injury experience a loss of sexual function.

Watch: Levels of Injury Explained – Thoracic – Spinal Cord Injury 101 https://spinalpedia.com/video/n6ay8ZBWDJb

– Watch: Levels of Injury Explained – High Cervical – Spinal Cord Injury 101 https://spinalpedia.com/video/Wzeyzmze1N2

https://en.wikipedia.org/wiki/Laminotomy#/media/File:715_Vertebral_Column.jpg

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