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Levels Of Injuries In The Spine

Brooklyn Pain Doc

Updated: Oct 8, 2024

There are different sections in the spine, and the dysfunction usually becomes more severe with higher spinal cord injuries.


Classification of Spinal Cord Injuries by NYPMR New York Pain and Injury Doctors.



Injuries In The Spine
Injuries In The Spine


Injuries In The Spine


High-Cervical Nerves (C1 — C4)

  • Most severe the spinal cord injury levels

  • Paralysis in arms, hands, trunk, and legs

  • Shortness of breath, cough, or control of bowel or bladder movements.

  • Speech may be impaired or reduced.

  • When all four limbs are affected, this is called tetraplegia or quadriplegia.

  • Needs help with eating, dressing, bathing, and getting in or out of bed.

  • They might use specialized powered wheelchairs to move independently.

  • The patient will not have the ability to independently operate a car.

  • Necessitates include round-the-clock personal care.


Low-Cervical Nerves (C5 — C8)

  • Corresponding nerves control arms and hands.

  • A person with this level of injury may be able to breathe on their own and speak normally.

C5 injury

  • A person can raise his or her arms and bend elbows.

  • Likely to have some or total paralysis of wrists, hands, trunk, and legs

  • Can speak and use a diaphragm, but breathing will be weakened

  • Will need assistance with most activities of daily living, but once in a power wheelchair, can move from one place to another independently

C6 injury

  • Nerves affect wrist extension.

  • Paralysis in hands, trunk, and legs, typically

  • Should be able to bend wrists back

  • Can speak and use a diaphragm, but breathing will be weakened

  • Can move in and out of wheelchair and bed with assistive equipment

  • May also be able to drive an adapted vehicle

  • Little or no voluntary control of bowel or bladder, but may be able to manage on their own with special equipment

C7 injury

  • Nerves control elbow extension and some finger extension.

  • Most can straighten their arm and have normal movement of their shoulders.

  • Can do most activities of daily living by themselves, but may need assistance with more difficult tasks

  • May also be able to drive an adapted vehicle

  • Little or no voluntary control of bowel or bladder, but may be able to manage on their own with special equipment

C8 injury

  • Nerves control some hand movement.

  • Should be able to grasp and release objects

  • Can do most activities of daily living by themselves, but may need assistance with more difficult tasks

  • May also be able to drive an adapted vehicle

  • Little or no voluntary control of bowel or bladder, but may be able to manage on their own with special equipment

Thoracic vertebrae are located in the mid-back. Thoracic Nerves (T1 — T5)

  • Corresponding nerves affect muscles, upper chest, mid-back and abdominal muscles.

  • Arm and hand function is usually normal.

  • Injuries usually affect the trunk and legs(also known as paraplegia).

  • Most likely use a manual wheelchair

  • Can learn to drive a modified car

  • Can stand in a standing frame, while others may walk with braces


Thoracic Nerves (T6 — T12)

  • Nerves affect muscles of the trunk (abdominal and back muscles) depending on the level of injury.

  • Usually results in paraplegia

  • Normal upper-body movement

  • Fair to good ability to control and balance trunk while in the seated position

  • Should be able to cough productively (if abdominal muscles are intact)

  • Little or no voluntary control of bowel or bladder but can manage on their own with special equipment

  • Most likely use a manual wheelchair

  • Can learn to drive a modified car

  • Some can stand in a standing frame, while others may walk with braces.


Lumbar Nerves (L1 — L5)

  • Injuries generally result in some loss of function in the hips and legs.

  • Little or no voluntary control of bowel or bladder, but can manage on their own with special equipment

  • Depending on strength in the legs, may need a wheelchair and may also walk with braces


Sacral Nerves (S1 — S5)

  • Injuries generally result in some loss of function in the hips and legs.

  • Little or no voluntary control of bowel or bladder, but can manage on their own with special equipment

  • Most likely will be able to walk



Spinal cord injuries resources:


The following organizations and resources provide assistance to individuals, families, friends, and caregivers of individuals with spinal cord injuries:


- Christopher and Dana Reeve Foundation

Phone: 973-379-2690 or 800-225-0292

- Miami Project to Cure Paralysis

Phone: 305-243-6001 or 800-782-6387

- National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Phone: 202-401-4634 or 202-245-7316

- National Rehabilitation Information Center (NARIC)

Phone: 301-459-5900 or 800-346-2742

- Paralyzed Veterans of America (PVA)

Phone: 800-424-8200

- United Spinal Association

Phone: 718-803-3782 or 800-962-9629

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