Levels of SCI – C1 to C8

Spinal Cord Injury Levels

A Summary of Spinal Cord Injury Levels: C1-C8

Traumatic spinal cord injury is a devastating irreversible life-changing condition often caused by incidents such as motorcycle accidents, trucking accidents, diving accidents, pedestrian accidents, bicycle accidents as well as assault, car accidents and falls.

The overall clinical outcome of a spinal injury depends on the area and severity of the lesion.  Typically, lower lesions in the thoracic area will cause paraplegia, while higher level lesions in the cervical region are associated with tetraplegia. Lesions and Damage to cervical vertebrae are the most serious of all spinal cord injuries.  Cervical vertebral bones are smaller than ones in your spine due to less weight to carry. Each specific level of the cervical spine is connected to a certain group of nerve endings and bodily functions. With each type of injury, there are various functions that could be affected, or sensations that may be lost due to damage. Cervical spine injuries are the most likely to lead to tetraplegia, wherein all four of the body’s limbs are paralysed.

If you or a loved one has suffered a severe or life-changing cervical spine injury, the right resources and information can be vital in your ongoing recovery and rehabilitation. This can be a difficult and frustrating time in your life, and the lives of your loved ones. Our Hamilton spinal cord injury lawyers have valuable resources that can assist you through this process, and we specialize in providing support for spinal cord injury victims throughout Ontario.

C1 to C4 Level Injuries

The cervical spine from levels C1 to C3 can be the most severe type of spinal cord injury an individual may suffer. These are at the highest level of the spinal cord, at the top of the neck and near the head, and can result in complete tetraplegia. C1 to C3 spine nerves are connected to the head, facial muscles, and ears. Individuals with C1 to C3 level spinal cord injuries may suffer some or all of the following:

• Paralysis of arms, hands, legs and torso
• Loss of control of the bladder and bowels – bladder & bowel routine help & management required
• Reduced ability to breathe  – cervical injuries above C4, in some circumstances may require a ventilator for a person to breathe
• The ability to speak is sometimes impaired
• SCI victims may be able to use powered wheelchairs
• 24 hour care required for for dressing, eating, bathing, grooming, and brushing teeth
• Assistance may be needed to clear secretions due to weak cough
• SCI vicitm may be independent to total assist needed for communication and telephoning, depending on adaptive devices such as a mouth stick and high-tech computer
• 24 hour assistance needed for housekeeping and home maintenance
• Total assistance needed for transportation in an accessible van or public transportation
• Total assistance needed for bed mobility
• Total assistance needed for wheelchair and bed transfers.
• May be independent in directing all transfers including hydraulic lift transfers.

C4 Level Injuries

The C4 is a crucial vertebral level – which they call “the big one”.  C4 spinal nerves run to the diaphragm, the muscle tissue that separates the abdomen from the thoracic cavity. The diaphragm is the main muscle of respiration. which contracts when you inhale. The contraction creates a vacuum which pulls air into the lungs. When you exhale air, yoour diaphragm relaxes and the air is pushed out of your lungs.

Fractures of the C4 can result in:

• Loss of your diaphragm function
• Ventilator dependence may or may not be present for patients with C4 injuries
• Pulmonary function can be compromised transiently by a superimposed infection such as the flu or pneumonia
• Total assistance may be needed to clear secretions with chest due to weak cough
• Bladder and bowel management needed
• Total assistance needed for dressing, eating, bathing, grooming, and teeth brushing
• Some individuals with C4 tetraplegia with some elbow flexion and deltoid strength may use a mobile arm support to assist with feeding, grooming, and bathing
• Telephoning can be achieved independently with speakerphone and mouthstick used to dial, or with voice recognition such as siri
• Voice recognition systems can be used for computers
• Total assistance needed for all housework and kitchen work

Life Expectancy with a C4 Spinal Cord Injury

• A 25-year-old can expect to live 32 years, in contrast to the normal life expectancy of 54 years.
• A 50-year-old can expect to live 13 years, in contrast to the normal life expectancy of 31 years.
• A 75-year-old can expect to live 2½ years, in contrast ■ to the normal life expectancy of 12 years.

C5 to C8 Level Injuries

The C5 to C8 nerves are associated with

• Control of deltoids (shoulders) and biceps
• Controls most of upper part of the arm to the elbow
• Wrist extensor muscles
• Lifting of the wrist
• Elongating fingers
• Outstretching your hand
• Triceps
• Finger movement

Individuals with C5 level spinal cord injury may have the following conditions:

• Limited arm movements – they can raise their arms or bend their elbows, but may have paralysis in the hands, wrists, and/or legs.
• Ability to speak, but difficulty breathing
• Loss of control or limited function in the bladder or bowel
• They are able to use motorized or powered wheelchairs to attain some degree of mobility.
• Individuals with C5 level injuries may be able to perform some daily tasks independently, but will more likely than not rely on ongoing assistance from a caregiver for most of their functions.

Individuals with C6 level spinal cord injury may have the following conditions:

• Paralysis in the hands, torso, and/or legs
• Wrists can generally still bend or function, but nerves that impact wrist extension could be limited or unpredictable
• Ability to speak, but limitations to breathing function
• Limited control or loss of function in the bladder or bowels
• A C6 level spinal cord injury is less severe than an injury at a higher level, and individuals may experience some degree of independence without the need for constant care.
• SCI c6 Victims are often able to utilize a wheelchair and transition themselves in and out of bed without assistance.
• With recovery, they may also be able to drive a modified assistive vehicle.

Individuals with C7 TO C8 level spinal cord injury may experience or may be:

• Tingling, numbness, and limited movement in the hands and the fingers
• Some shoulder movements and arm flexibility, but severe or burning pains in the shoulder blades and triceps
• Lack of control in the bowel and/or bladder
• Weakened breathing, but without the need for a ventilator or assistance
• Indepndendant with most activities of daily living but may need assistance with more difficult tasks
• Men can be independent with intermittent catheterization using assistive devices
• Women may be independent or may need assistance for emptying a urinary drainage bag
• Potentially independent for performance of bowel routine with assistive devices including a digital stimulator, suppository inserter, and mirror
• Modified independent upper and lower body dressing with adaptive equipment such as button and zipper aids
• Modified independent teeth cleaning with built up toothbrush, electric toothbrush, or universal cuff
• Independent upper extremity bathing and some to total assistance needed with lower body bathing with adaptive equipment, for example, a wash mitt, handheld shower, lever-type faucet, grab bars, and tub transfer bench or preferably a roll-in shower chair
• Independent eating after setup although may need universal cuff or utensils with built up handles
• Independent to some assistance after setup for use of telephone and writing
• A typing splint is often necessary for typing
• Independent light meal preparation and light housework Total assistance needed for heavy housework

As for mobility, some individuals with C7 – C8 SCI may:

• Be independant with driving a car or a van with hand controls
• Require minimum assistance to independent for bed mobility
• Require minimal assistance to modified independent with transfer board for transfers
• Be independent power wheelchair mobility
• Independent ultra lightweight manual wheelchair mobility with modified hand rims

If you have suffered a cervical spinal cord injury, we can help.

Since 2003, we have been assisting spinal cord injury victims and their families throughout Ontario.  Our spinal cord injury lawyers have helped families in Hamilton and all over Ontario secure compensation after suffering a spinal cord injury caused by the negligence of others. There’s no doubt that suffering a spinal cord injury will cost you and your families millions in care and rehabilitaion over the course of your life. There are numerous economic and non-economic damage claims that can be made against the insurance company of a person or company that causes your injury to help you recover money for pain and suffering, loss of pages wages, future wages, loss of pension accural, health and dental benefits, ongoing rehabilitation, occupational therapy, home and transportation adaptation as well as assistive devices and health care product replacements for life.  Call our offices at 905-333-8888 or contact us through our online contact form to learn more about how we can assist you with your recovery.

*Special thanks to pubmed, the ABC’s of SCI, The Essentials of Spinal Cord Injury, Dr.Gladsway and Spinal Cord Injury Rehabilitation Medicine Quick Reference