What is a complete vs incomplete injury?
Understanding your SCI
Spinal cord injury (SCI) occurs when the bony protection surrounding the cord is damaged by way of fractures, dislocation, burst, compression, hyperextension or hyperflexion.
The most common cause of spinal cord dysfunction is trauma, including motor vehicle accidents, falls, shallow diving, acts of violence, and sports injuries. Damage can also occur from various diseases acquired at birth or later in life, from tumors, electric shock, and loss of oxygen related to surgical or underwater mishaps.
The spinal cord does not have to be severed in order for a loss of function to occur. It can be bruised, stretched, or crushed.
Since the spinal cord coordinates body movement and sensation, an injured spinal cord loses the ability to send and receive messages from the brain to the body’s system that controls sensory, motor, and autonomic function.
Some of the resultant types injury go by the terms cauda equina, conus medularis, central and anterior cord syndrome, or Brown-Sequard syndrome.
The location of the spinal cord injury dictates the parts of the body that are affected.
After a complete neurological examination, the doctor will assign a level of injury and determine if the injury is complete or incomplete. The initial level of injury and function may also change upon discharge to rehabilitation.
It is important to remember that these are general guidelines and that individual outcomes will vary.
Cervical spinal cord injury C1-C8
Cervical level injuries cause paralysis or weakness in both arms and legs, resulting in quadriplegia (also known as tetraplegia). This area of the spinal cord controls signals to the back of the head, neck, shoulders, arms, hands, and diaphragm.
Since the neck region is so flexible it is difficult to stabilize cervical spinal cord injuries. Individuals may be placed in a brace or stabilizing device.
All regions of the body below the level of injury or top of the back may be affected. At times, a cervical injury is accompanied by the loss of physical sensation, respiratory issues, inability to regulate body temperature, bowel, bladder, and sexual dysfunction.
Thoracic spinal cord injury T1-T12
Thoracic level injuries are less common because of the protection given by the rib cage.
Thoracic injuries can cause paralysis or weakness of the legs (paraplegia) along with loss of physical sensation, bowel, bladder, and sexual dysfunction.
In most cases, arms and hands are not affected. This area of the spinal cord controls signals to some of the muscles of the back and part of the abdomen.
With these types of injuries most patients initially wear a brace on the trunk to provide extra stability and help build up core muscles.
Lumbar spinal cord injury L1-L5
Lumbar level injuries result in paralysis or weakness of the legs (paraplegia). Loss of physical sensation, bowel, bladder, and sexual dysfunction can occur. However, shoulders, arms, and hand function are usually unaffected.
The lumbar area of the spinal cord controls signals to the lower parts of the abdomen and the back, the buttocks, some parts of the external genital organs, and parts of the leg. These injuries often require surgery and external stabilization.
Sacral spinal cord injury S1-S5
Sacral level injuries primarily cause loss of bowel and bladder function as well as sexual dysfunction. These injuries can cause weakness or paralysis of the hips and legs.
The sacral area of the spinal cord controls signals to the thighs and lower parts of the legs, the feet, and genital organs.
Complete vs. incomplete
One of the terms you will hear often in reference to your spinal cord injury is complete or incomplete.
An incomplete injury means that the ability of the spinal cord to convey messages to or from the brain is not completely lost. Additionally, some sensation (even if it’s faint) and movement is possible below the level of injury.
A complete injury is indicated by a total lack of sensory and motor function below the level of injury.
The absence of motor and sensory function below the injury area does not necessarily mean there are no remaining intact axons or nerves crossing the injury site, just that they are not functioning appropriately as a result of the trauma.