Complete and Incomplete Spinal Cord Injury

Understanding Spinal Cord Injury (SCI)

Spinal cord injury is the result of a violent physical trauma which damages the spinal cord. There are many causes of spinal cord injury including car accidents, motorcycle crashes, sports injuries and falls. One of the more common spinal cord injury types is incomplete spinal cord injury. But many people are not sure what the difference is between this and complete SCI. Here is a quick guide to better understand the two.

A spinal cord injury (SCI) occurs when the spinal cord is damaged, causing permanent changes in sensation, movement, or both.  Essentially, the spinal cord is a bundle of nerves that runs from the brain to each part of your body. It acts as a relay station transmitting information between your brain and your body parts. For example, a damaged spinal cord could prevent you from being able to feel pain, heat, cold or touch an object with any part of your body.

It was previously assumed that the spinal cord had to be severed in order to lose function. But that is not the case. It can be bruised, compressed, or crushed as well.

What Determines the Body Parts That Are Affected

The location of the injury will determine which body parts are affected.  There are 4 main areas where damage often occurs such as Cervical, Thoracic,  Lumbar, and Sacral.  Cervical injury involves the neck and upper body.  The other areas descend along the lower body and will affect those parts of the body in those areas.

You may be familiar with celebrities who have had spinal cord injuries such as actor Christopher Reeve, former US Olympic swimmer Amy Van Dyken, musician Teddy Pendergrass, and actor Darrel “Chill” Mitchell, a member of the 1990’s sitcom Veronica’s Closet with Kirstie Alley.

Diagnosing a Spinal Cord Injury

A doctor will perform a complete physical and neurological examination and assign a level of injury when determining whether or not an SCI is complete or incomplete.  This number may change in the future depending on the possibility of treatment.

Incomplete spinal cord injuries occur when only some parts of the spinal cord are damaged. Complete spinal cord injuries occur when all parts of the spinal cord are damaged. Complete spinal cord injuries are also referred to as quadriplegia or tetraplegia, depending on which limbs are affected. The level of the spine where the injury occurs determines whether or not an incomplete or complete injury exists.

Complete and incomplete SCI are described using five designations: T1-12, T1-T12, T1-L1, T2-12 and T2-T12. These designations refer to specific levels in the spine where damage can occur.

The higher up on the spinal column an injury occurs (for example, at the C5 vertebra), the more limited a person’s range of motion and function will be after an injury. A person with a cervical (C5-C7) injury might be able to move his or her arms and hands but have limited head, neck, and diaphragm movement. People with this type of injury may use a ventilator because breathing is one of the functions affected.

Summary of the Different Types of Injury

Cervical spinal cord injury C1-C8

Damage to the upper part of the spine (between the neck and shoulders) can cause loss of movement, sensation, or both in parts or all of the limbs on one side of the body. It is caused by damage to one or more vertebrae in the neck region. The extent of paralysis depends on which nerve roots are injured, how much they are injured, and where they are located.

Tetraplegia (also called quadriplegia) involves all four limbs, both sides of the body, and occurs when a person has an incomplete spinal cord injury at C1-C8.

Paraplegia (also called paraparesis) involves only one side of the body and only occurs when a person has an incomplete spinal cord injury at T1-L3.

People with cervical injury may require the use of a brace to stabilize the spine since the neck is so flexible.

Thoracic spinal cord injury T1-T12

Thoracic injuries can cause paralysis or weakness of the legs (paraplegia) along with loss of physical sensation, bowel, bladder, and sexual dysfunction. Parts of the upper body such as the arms and hands are unaffected. A brace can help stabilize the trunk area and strengthen core muscles.

T1-T12 spinal injuries encompass a large range of potential symptoms and severity. The nerve roots that emerge from each vertebra travel down the length of your torso to innervate different parts of your body. As a result, injuries at this level can cause a wide range of symptoms and conditions. Injuries at T1, T2, T9 and T10 are almost always complete injuries whereas injuries at T11 and T12 can be either complete or incomplete depending on the location of damage in relation to the major nerves emerging from these levels.

Lumbar spinal cord injury L1-L5

Lumbar level injuries result in weakness or loss of function in the legs (paraplegia). There may be limited to no physical sensation, as well as bowel and bladder function. Most often, the arms, shoulders, and hands are unaffected.

The first and second lumbar segments (L1 to L2, L2 to L3) are responsible for flexing the hip, knee, and ankle joints. The third and fourth lumbar segments (L3 to L4, L4 to L5) extend these joints.

Sacral spinal cord injury S1-S5

Sacral spinal cord injuries affect the thighs, legs, and sexual organs. With this type of injury, the patient may have no physical sensation below the affected area such as no bladder, bowel, or sexual functions.

Complete and incomplete spinal cord injury

Injury to the spinal cord can cause a wide variety of symptoms, depending on where it occurs in the spinal column, and how many segments are affected. A spinal cord injury (SCI) may result in paralysis, loss of sensation, or loss of function below the point of injury. Some injuries may be “complete” in which the spinal cord is severed and there is no communication between the brain and the areas below it. In other cases, the injury may be “incomplete” in that there is some preservation of nerve connections below a specific level.

An example of a complete spinal cord injury would be that of Christopher Reeve, who was injured after being thrown from his horse during an equestrian competition. His injury affected the C-1 and C-2 area of the spinal cord.

A person with incomplete spinal cord injury may retain some sensation in parts of the body above or below the injury.  An example of this would be wheelchair rugby player Mark Zupan, who was paralyzed from the waist down after a car accident.

Despite having devastating injuries, celebrities, journalists, and other media personalities continue to make an impact on the world around them.  Christopher Reeve was an outstanding actor and later an outspoken advocate for stem cell research.

While there is no “fix” for spinal cord injuries, some people have been able to recover some function through physical therapy and stem cell treatments like Angela Rockwood, a quadriplegic who was able to regain the mobility of her arms.

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