A C5 spinal cord injury (SCI) features damage to the cervical vertebral segment, also referred to as the cervical spine. The cervical portion of the spine commences at the base of the skull where the first vertebrae – the Atlas – holds up the head at the Occiput (the lower back of the head). This is called the Atlanto-Occiput Junction. C4/
C5 SCI are the most common spinal cord injuries and make up the majority of the 50.5% of spinal cord injuries that cause tetraplegia (formerly referred to as quadraplegia) each year.
The Atlas is vertebrae 1 on the cervical spine, so it is called C1. The 5th vertebrae down from the Atlas is thus the C5, approximately under which the C5 area of the spinal cord exists. As with all spinal cord injuries, the resulting damage and paralysis affects all of the body parts controlled by the nerves located at and beneath the injury site on the cord. So, a C5 SCI is one of complete or incomplete tetraplegia as the sensation and movement of the four limbs originate beneath the C5. Although the patient will suffer total paralysis from the neck downward, they may have some function if the injury is an incomplete SCI.
Effects and Limitations
C5 spinal cord injury patients typically will not have any control of their hands or wrists but can have some control of their shoulders and biceps. Other likely effects of a C5 SCI include inability for the body to regulate heart rate, body temperature, blood pressure, and perspiration, as well as bowel and bladder dysfunction, sexual dysfunction, spasticity, neuropathic pain, muscle atrophy, osteoporosis, and gallbladder and renal stones.
Prognosis and Treatment of C5 Spinal Cord Injury
Patients with a C5 spinal cord injury are first seen by physicians in an acute care setting such as an emergency room, where they are treated to prevent as much additional damage to the spinal cord, vertebrae, and surrounding tissue as possible. Controlling swelling, stabilization of the back, and removal of bone fragments, foreign objects, and other potentially harmful matter are the immediate objectives for a trauma team treating a new spinal cord injury patient.
Three days post-injury, the patient is assessed by their physician(s) through use of the ASIA scale and other diagnostic testing to determine the severity of the injury. Upon determination of the patient’s precise condition, treatment options including rehabilitation are prescribed. The average acute care hospital stay for a patient with a spinal cord injury is 12 days and is followed by a 37 day inpatient rehabilitation center stay, according to the University of Alabama National Spinal Cord Injury Statistical Center’s report of 2009.
Rehabilitation of C5 Spinal
For a C5 SCI patient, extensive and long-term rehabilitation will focus upon aiding the injured in adapting to his or her condition through physical, psychological, occupational, and recreational therapies. This rehabilitation will include assignment of functional goals for the patient to achieve toward maximum independence. Some of the goals for a C5 spinal cord injury patient are:
- Daily Life: Ability to feed oneself using feeding strap and fork or spoon; drink, wash face, brush teeth, shave face, and take care of hair with aid in setting up of adaptive devices;
- Health Regimen: Management of own health care through assisted coughing and relieving of pressure on body through forward or sideways leaning; breathing without a ventilator through use of their own diaphragm
- Mobility: Daily use of power wheelchair with hand controls, with potential of some use of a manual wheelchair for short distances and on smooth surfaces, as well as potential to drive an adapted car with hand controls
- Occupation: Use of a computer through voice recognition or a typing stick and use of a telephone through a headset with voice recognition
- Recreation: Exploration and enjoyment of recreational and outdoor activities through adaptation or use of adaptive devices
While many daily pursuits will require assistance and domestic care will always be necessary for tasks such as household cleaning, laundry, meal preparation, and general home maintenance, patients of C5 spinal injuries still can enjoy a long, fulfilling life. Adjustment to their new circumstances is often an emotional and frustrating course for C5 SCI patients. But over time, progress will be made and opportunities for functionality through adaptive devices present the potential to live and work toward many of the same goals as before the injury.
Learn more about c7 spinal cord injury.