Lower-Level Spinal Cord Injury (SCI): What to Expect
Damage or disease of the spinal cord often results in weakness, paralysis, changes in your feeling, and changes in bodily functions like bladder and bowel. You are likely interested in the effects of a spinal cord injury. And more importantly, how much you CAN do. Each person's outcome after a spinal cord injury is unique. But there are a few general things to know about injuries like yours. This sheet will give you and your loved ones a brief overview of what to expect with your level of injury. For more specifics about your case, ask your SCI team.
The Spinal Cord
The spinal cord is located in the neck and back. It is surrounded by bones of the spine (vertebrae). It is best to think of the spinal cord as continuous and an extension of the brain. This is because the make-up of the spinal cord and brain are very similar. The spinal cord relays information between nerves of the body (spinal nerves) and the brain. That information includes messages about feeling (sensation such as pain, temperature, and touch), movement, and organ function.
Spinal Cord Injury and Understanding Levels of SCI
A spinal cord injury is described by the region that was injured, a specific level of injury, and the completeness of the injury. The level of injury determines what parts of the body are affected. In general, sensation, movement, and function are lost at and below the level of the injury.
Region. There are four general spinal cord regions. They are named after the spine and bones of that region. These include: cervical (C) in the neck, thoracic (T) in the upper back, lumbar (L) in the lower back, and sacral (S) in the pelvic region. Therefore, a spinal cord injury in the neck region is described as a cervical spinal cord injury. In the upper back, the injury would be described as a thoracic spinal cord injury. In the lower back, the injury is described as a lumbar SCI. And in the pelvic region, the injury would be described as a sacral injury.
Specific level. In each of the regions, there are specific levels designated by a number. The number corresponds to the bones in the region. In the cervical region, there are eight specific levels, named as cervical 1 (abbreviated C1), cervical 2 (C2), cervical 3 (C3), and so on. There are 12 specific levels in the thoracic region, five in the lumbar region, and five in the sacral region.
Completeness of injury. Spinal cord injuries and disorders are described as complete (meaningful movement and feeling below the level of injury are lost) and incomplete (some nerve fibers are working and there is some meaningful feeling and/or movement below the level of injury). The exact definition of a complete or incomplete injury sometimes confuses people. Ask your SCI team if you have questions.
Know the level of your injury and its completeness. If you do not know or understand your injury, be sure to take to your SCI team.
Expected Outcomes After Lower-Level SCI
Changes to expect after an SCI depend upon many factors. In general, an injury that involves lower levels (thoracic, lumbar or sacral regions) will cause paraplegia. This means "two-limb paralysis." A person with a lower-level SCI will lose some or all sensation and/or movement in their trunk or legs. They will have full feeling and movement in their arms and hands. Functions like coughing are sometimes affected because the trunk may be weak. People with a lower-level SCI will be able to do many personal-care and day-to-day activities on their own. But assistance with certain activities may be needed.
In addition to expected outcomes for movement, sensation, and function, it is also important to consider other outcomes. These include social participation and life satisfaction. After the initial period of adjustment, many people with SCI report excellent quality of life. And many have high levels of social participation. Their social and life satisfaction is not related to their level of SCI.
Everyone Is Different!
It is important to note that outcomes are different from person to person, even with the same level of injury. Many factors are involved. Injuries may change over time. Your abilities and function can change too. Work with your SCI team to learn what outcomes you might expect with your injury, and what goals you should work toward.
A Lifelong Goal
You will meet with your SCI team to monitor your progress. To ensure you are getting the best care possible, be sure to have your wellness health check every year. Also work closely with your local SCI team. Your team is there to support you in setting goals and achieving the best function possible.