The location of the spinal cord injury dictates the parts of the body that are affected. After a complete examination, the doctor will assign a level of injury. The doctor will also determine if the injury is complete or incomplete. The level of injury and function may change; the initial level of injury may not be the same level upon discharge to rehabilitation. It is important to remember that these are general guidelines and that individual outcomes will vary.
Spinal cord injury occurs when the bony protection surrounding the cord is damaged by way of fractures, dislocation, burst; compression,
hyperextension or hyperflexion; Some of the resultant types injury go by the terms cauda equina, conus medularis, central and anterior cord syndrome, or Brown-Sequard syndrome.
Cervical Spinal Cord Injury C1 – C8 — Quadriplegia also known as Tetraplegia
Cervical level injuries cause paralysis or weakness in both arms and legs (quadriplegia). All regions of the body below the level of injury or top of the back may be affected. Sometimes this type of injury is accompanied by loss of physical sensation, respiratory issues, bowel, bladder, and sexual dysfunction. This area of the spinal cord controls signals to the back of the head, neck and shoulders, arms and hands, and diaphragm. Since the neck region is so flexible it is difficult to stabilize cervical spinal cord injuries. Patients with cervical level injuries may be placed in a brace or stabilizing device.
Thoracic Spinal Cord Injury T1- T12
Thoracic level injuries are less common because of the protection given by the rib cage. Thoracic injuries can cause paralysis or weakness of the legs (paraplegia) along with loss of physical sensation, bowel, bladder, and sexual dysfunction. In most cases, arms and hands are not affected. This area of the spinal cord controls signals to some of the muscles of the back and part of the abdomen. With these types of injuries most patients initially wear a brace on the trunk to provide extra stability.
Lumbar Spinal Cord Injury L1-L5
Lumbar level injuries result in paralysis or weakness of the legs (paraplegia). Loss of physical sensation, bowel, bladder, and sexual dysfunction can occur. The shoulders, arms, and hand function are usually unaffected. This area of the spinal cord controls signals to the lower parts of the abdomen and the back, the buttocks, some parts of the external genital organs, and parts of the leg. These injuries often require surgery and external stabilization.
Sacral Spinal Cord Injury S1 – S5
Sacral level injuries primarily cause loss of bowel and bladder function as well as sexual dysfunction. These types of injuries can cause weakness or paralysis of the hips and legs. This area of the spinal cord controls signals to the thighs and lower parts of the legs, the feet, and genital organs.
Complete and Incomplete:
An incomplete injury means that the ability of the spinal cord to convey messages to or from the brain is not completely lost; some sensation and movement is possible below the level of injury. A complete injury is indicated by a total lack of sensory and motor function below the level of injury. But the absence of motor and sensory function below the injury site does not necessarily mean that there are no remaining intact axons or nerves crossing the injury site, just that they do not function appropriately following the injury.