Types of Spinal Cord Injuries

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Man with spinal cord injury in wheelchair with his sons reading a tablet
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The nerves of the spinal cord enable your body to move, feel things, and perform vital activities like breathing. When the nerves of the spinal cord become injured or irritated, paralysis (loss of movement), loss of sensation, and even total loss of function can occur. These issues can be temporary or permanent, depending on the type of spinal cord injury (SCL), its severity, and its location along the spinal column. Doctors classify spinal cord injuries based on type and the neurological level of injury (or simply “level”).

The Two Types of Spinal Cord Injury

If a person is exhibiting the signs of an SCI, doctors will first classify it as “complete” or “incomplete.” Doctors use the American Spinal Injury Association (ASIA) grading scale to evaluate nervous function and sensation to precisely diagnose the type of injury.

  • Complete spinal cord injury causes a total loss of function and sensation below the neurological level of injury (the injury’s location along the spinal cord).
  • Incomplete spinal cord injury involves a partial loss of function or sensation below the level of the injury.

Many people think a “complete” spinal cord injury means the spinal cord was severed (cut in half), but this is not often the case. More usually, a complete SCI means the spinal cord simply becomes damaged beyond its ability to repair itself, often due to serious dislocation or fracture of the vertebrae (bones of the spinal column).

An incomplete SCI involves excessive inflammation of the spinal cord due to trauma. Football players, for example, can experience a spinal cord injury that causes arm or leg weakness, partial loss of bladder function, or other symptoms for some period of time due to trauma caused during game play. These injuries may heal in time, with restored function and sensation, or the partial loss of function and sensation may be permanent.

Spinal Cord Injury Levels

A spinal cord injury can occur anywhere along the spine. In classifying an SCI, doctors will note the level of the neurological injury, as well as the type (complete or incomplete).

Doctors divide the vertebrae of the spine into three groups: the cervical spine (the eight bones of the neck), the thoracic spine (the 12 vertebrae of the mid-back), the lumbar spine (five bones of the lower back), and the sacrum (five bones of the “tailbone”). Doctors note the level of injury because SCIs affect movement and sensation below the injured level.

A C5 spinal cord injury, for example, occurs at the level of the fifth cervical vertebra in the neck, a bone roughly situated behind the Adam’s apple. A complete injury at this level can be fatal, or it can affect the entire body below that point of the spine, including a total loss of sensation and function from the neck down. People who survive a complete C5 spinal cord injury lose their ability to breathe, since that function is controlled by nerves located below the C5 level.

The L1 (first lumbar vertebra) level is located in the lower spine, approximately behind the bladder. An incomplete spinal cord injury here can produce symptoms that affect movement and sensation of the legs.

SCI diagnoses always include both the type and level, such as “complete T3 spinal cord injury.” This important information helps direct treatment plans and self-care activities.

When to Seek Medical Care for a Spinal Cord Injury

The symptoms of an incomplete SCI can manifest hours or days after an injury occurs. If you have been in an auto accident, had a bad fall, or experienced a high-velocity impact during athletic activity, be alert for the signs and symptoms of a spinal cord injury, which can include:

  • Difficulty breathing that does not clear up quickly
  • Feeling as if there’s a tightening band around your chest or rib cage area
  • Loss of bladder control, feeling as if you have to urinate frequently, or the inability to urinate
  • Loss of sensation or tingling in an extremity that doesn’t go away
  • Severe pain or pressure in the head, the neck, or anywhere along the spine
  • Visible bumps on the head or spine
  • Weakness in the arms, hands, legs, or feet

Prompt diagnosis and treatment of spinal cord injuries is crucial to avoid lifelong complications. Never attempt to move a person who is unconscious or has lost function or sensation in their extremities. Call 911 for emergency medical assistance.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Apr 6
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