levels of injury

By | July 2, 2017

Understanding Spinal Cord Injury Levels

Overview Of The Spinal Cord

In order to know more about the spinal cord injury levels, people have to get knowledge about the spinal cord itself. Our spinal cord is directly connected to the brain. It descends down the middle of the back part of the body and is protected and covered in the vertebral column. In addition, it is also surrounded by a clear fluid known as cerebral spinal fluid (CSF). This fluid acts as a cushion to protect the nerve tissues from any damages.

The spinal cord consists of millions of nerve fibers that transmit information from the trunk, limbs, body organs and back to the brain. The nerves located on the upper section of the spinal cord are responsible for the control of breathing and the arms. Meanwhile, the nerves located in the mid and the lower part of the cord govern the trunk and the legs, and also the bowel and bladder function. Motor neurons are known to carry information from the brain to the muscles. On the other hand, sensory neurons are the types of neurons responsible for the relay of information from the back to the brain. This also lets the brain know information about the temperature, touch, joint position and pain.

What Are Spinal Nerves?

Spinal nerves, or nerve roots, make up the spinal cord and they branch out. They pass out to a hole in every segment of the vertebrae known as the foramen. These nerves primarily carry information from the spinal cord to the different parts of the body, then from the body back to the brain. A human’s spinal nerves can be classified into four main groups that exist several levels of the spinal cord.

Cervical Nerves (C)
Thoracic Nerves (T)
Lumbar Nerves (L)
Sacral Nerves (S)

The cervical nerves are responsible for the movement and the sensation of the arms, upper trunk, and the neck. It also controls the breathing pattern of a person. The thoracic nerves supply the abdomen and the trunk. Meanwhile, the lumbar nerves and the sacral nerves are the nerves that supply the legs, bowel, and the sexual organs.
Numbering Scheme Of The Spinal Cord Level

The spinal nerves distribute information to and from the different segments of the spinal cord. Both the segments and the nerves in the spinal cord are numbered to correspond to the vertebrae. Conus Medullaris is the junction where the spinal cord ends. It takes place in the L1 and L2 of the lumbar nerves. Even though the spinal cord ends up in one spot, the spinal nerves continue to branch out as a bundle of nerves known as the cauda equina.


The spinal nerves have 31 pairs branching out from the spinal cord. The spinal nerves exit right above the vertebrae in the cervical region. However, there is a change in the C7 vertebra. The C8 spinal nerve leaves the vertebra below the C7. This signifies that there is an 8th cervical spinal nerve, but there is no 8th cervical vertebra. Starting from the first thoracic vertebrae going downwards, all spinal nerves will exit their corresponding vertebrae.


On the other hand, the spinal nerves that exit the spinal cord are numbered related to the vertebra where they exit from the spinal cord. The spinal nerve known as T4 exits the spinal cord through the 4th thoracic vertebra’s foramen. The L5 exits the spinal column from the Conus medullaris and goes to the cauda equina until it leaves the number five lumbar vertebra. Nevertheless, it is important to know that the spinal cord segment levels are not exactly related to the vertebral body levels.

These segments, nerves, and numberings are essential to identify the spinal cord injury level and how to treat it properly.

Levels Of Spinal Cord Injury – How Severe Can It Be?

Like what was mentioned above, the vertebrae are grouped into segments and sections. You must know that the higher the injury to the spinal cord, the more severe and life-threatening the dysfunction can occur. The levels of spinal cord injury must be known to take advantage of treating the root cause of the problem.

Here is the list of the different levels of the spinal cord and the body functions that might get affected if a person suffers from an injury related to it:
High-Cervical Nerves (C1-C4)

Damages in these sections are the most severe of all injuries related to the spinal cord
Paralysis might take place in the arms, hands, trunk and the legs
Impaired speech
Needs extensive assistance to go on with activities of daily living
A patient may lose his control over bowel and bladder, as well as coughing and even worse, breathing
All limbs may be affected, resulting in quadriplegia
Requires care 24 hours a day
May need to have an electronic wheelchair to help them move around

Low-Cervical Nerves (C5-C8)

These nerves govern the hands and the arms
A person suffering from this level of spinal cord injury may be able to breathe on their own and speak the usual way.

C5 Injury

Signifies a total paralysis of the hands, wrists, legs, and trunk
Can be able to use the diaphragm, but breathing is somehow impaired
Must have an assistant to go on with activities of daily living and can move independently with the aid of a power wheelchair.

C6 Injury

Patients suffering from injuries of the C6 nerves might be able to speak, but breathing is still weak.
There is little or no voluntary control regarding the bowel or bladder, but patients can do so by using special equipment
Paralysis felt in the hands, legs, and trunk

C7 Injury

These nerves are responsible for the extension of the elbow and the fingers
Most people suffering from this level of injury can still straighten their arms and have a normal shoulder movement.
Just like C6, there is little to no voluntary bladder and bowel control

C8 Injury

Nerves responsible for controlling hand movement
Patients suffering from this injury can still hold and release several objects
Can go on with their activities of daily living by their own, but need assistance with some difficult tasks.

Thoracic Nerves (T1-T5)

Nerves affecting the muscles, mid-back, abdominal muscles and the upper chest
It is usually normal for the function of the arms and the hands
Can walk with the help of braces and can stand using a standing frame
Injuries related to these nerves commonly affect the leg and the trunk or known as paraplegia.
May use a manual wheelchair

Thoracic Nerves (T6-T12)

Nerves affecting the trunk muscles depending on the injury level
Patients have a normal movement of the upper body
They can also cough productively
While in the sitting position, patients can control and balance their trunk fairly
May result in paraplegia
Can walk with the help of braces and can stand using a standing frame

Lumbar Nerves (L1-L5)

Any injuries in this area will result in some loss of the function of the hips and the legs
There is no voluntary bladder or bowel control, but sufferers can still manage to do it on their own using special equipment
Patients may need to use a wheelchair or walk with braces depending on their leg strength

Sacral Nerves (S1-S5)

Damages will affect the function of the hips and the legs
There is a higher chance that a patient can still walk
There is no voluntary bladder or bowel control, but sufferers can still manage to do it on their own using special equipment

Depending on the severity and the extent of the injury, a patient must seek help from the most effective rehabilitation of their condition. These days, selecting the best facility or clinic offering strength training for people suffering from spinal cord injuries is important to address the problem and recover from it. This will help patients regain their normal lives.

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