Spinal Cord Injury Types

The location and completeness of a spinal cord injury will greatly alter the prognosis for the patient. Find out the most common types of spinal cord injuries and how they impact the function of the body.

Author: Spinalcord.com Team

Publish Date: Dec 02, 2020

An estimated 12,500 spinal cord injuries occur in the U.S. every year, leaving the injured people, their friends, and their family, to cope with the aftermath of the catastrophe. For many, navigating the challenges of the health care system can feel a bit like going to medical school. Suddenly you're learning a veritable cornucopia of new terms, and may be spending endless hours Googling spinal cord anatomy to fill in the gaps in your knowledge.

An educated patient is better equipped to advocate for his or her needs and interests. An education in spinal cord anatomy helps you understand what your doctor is saying, ask intelligent questions, and detect medical errors before they endanger your health.

Spinal Cord Anatomy: The Basics

Though you might think of your spinal cord as one single piece, it's actually a column of nerves protected by a sheath of myelin and then further secured by 31 butterfly-shaped vertebrae (singular: vertebra).

Medical providers divide the spinal cord into four distinct regions. Knowing the region in which the injury is located is often the key to understanding your diagnosis and treatment.

Medical Professional Pointing to Spinal Cord - Spinal Cord Anatomy - The Basics

The four spinal cord regions are:

The cervical spinal cord: This is the topmost portion of the spinal cord, where the brain connects to the spinal cord, and the neck connects to the back. This region consists of eight vertebrae, commonly referred to as C1-C8. All spinal cord numbers are descending, so C1 is the highest vertebra, while C8 is the lowest in this region.
The thoracic spinal cord: This section forms the middle of the spinal cord, containing twelve vertebrae numbered T1-T12.
The lumbar spinal cord: This is a lower region of the spinal cord, where your spinal cord begins to bend. If you put your hand in your lower back, where your back bends inward, you're feeling your lumbar region. There are five lumbar vertebrae, numbered L1-L5.
The sacral spine: This is the lower, triangle-shaped region of the spine, also with five vertebrae. While the lumbar spine’s vertebrae bends inward, the vertebrae of the sacral region bend slightly outward. There is no actual spinal cord in this section, it is made up of nerve roots which exit the spine at their respective vertebral levels.

Spinal Cord Injury Types

What is a spinal cord injury? Put simply, there are two main categories of spinal cord injuries: Complete and Incomplete

Complete Spinal Cord Injuries

Complete SCIs are the most serious and occur when the spinal cord is injured, eliminating the brain’s ability to send signals below the injury site. For an injury impacting the lumbar spinal cord, for example, it can lead to paralysis below the waist while preserving your motor functions in your upper body and arms (paraplegia). For complete injuries in the cervical spine, however, this often leads to a loss of motor function in the lower and upper body (tetraplegia, which is also known as quadriplegia).

Incomplete Spinal Cord Injuries

Incomplete SCIs commonly result from compression or damage being inflicted to the spinal cord that reduces the brain’s ability to send signals below the injury site. Because of the partially-compromised condition of the spinal cord, incomplete injuries vary drastically from person to person. Some sensory and motor functions may be slightly compromised in some or nearly eliminated in others. Additionally, some incomplete injuries result in triplegia, or the loss of sensation and movement in one arm and both legs.

Incomplete spinal cord injuries are increasingly common, thanks in part to better treatment and increased knowledge about how to respond—and how not to respond—due to improved spinal cord injury research. These injuries now account for more than 60% of spinal cord injuries, which means we're making real progress toward better treatment for SCI rehabilitation.

Some of the most common types of incomplete or partial spinal cord injuries include:

Anterior cord syndrome: This type of injury, to the front of the spinal cord, damages the motor and sensory pathways in the spinal cord. You may retain some sensation, but struggle with movement.
Central cord syndrome: This injury is an injury to the center of the cord, and damages nerves that carry signals from the brain to the spinal cord. Loss of fine motor skills, paralysis of the arms, and partial impairment—usually less pronounced—in the legs are common. Some survivors also suffer a loss of bowel or bladder control, or lose the ability to sexually function.
Brown-Sequard syndrome: This variety of injury is the product of damage to one side of the spinal cord. The injury may be more pronounced on one side of the body; for instance, movement may be impossible on the right side, but may be fully retained on the left. The degree to which Brown-Sequard patients are injured greatly varies from patient to patient.

Knowing the location of your injury and whether or not the injury is complete can help you begin researching your prognosis and asking your doctor intelligent questions about your SCI rehabilitation. Doctors assign different labels to spinal cord injuries depending upon the nature of those injuries. The most common types of spinal cord injuries include:

Tetraplegia: These injuries, which are the result of damage to the cervical spinal cord, are typically the most severe, producing varying degrees of paralysis of all limbs. Sometimes known as quadriplegia, tetraplegia eliminates your ability to move below the site of the injury, and may produce difficulties with bladder and bowel control, respiration, and other routine functions. The higher up on the cervical spinal cord the injury is, the more severe symptoms will likely be.
Paraplegia: This occurs when sensation and movement are removed from the lower half of the body, including the legs. These injuries are the product of damage to the thoracic spinal cord. As with cervical spinal cord injuries, injuries are typically more severe when they are closer to the top vertebra.
Triplegia: Triplegia causes a loss of sensation and movement in one arm and both legs, and is typically the product of an incomplete spinal cord injury.

Spinal Cord Injury Symptoms

A spinal cord injury is not the sort of thing you have to wonder about having. If you've suffered a spinal cord injury, your life is in danger, and you'll know you're injured. You can't use symptoms to diagnose the sort of spinal cord injury you have, and every patient's prognosis is different. Some make a miraculous recovery within months; others need years of physical therapy and still make little to no progress.

The outcome depends on the nature of the injury, the quality of medical care you receive, the degree to which you work at your own recovery by adopting a healthy lifestyle, your psychological health, luck, and innumerable other factors.

Spinal Cord Injury- Close up image of a spinal cord

A partial list of common spinal cord injury symptoms includes:

Varying degrees of paralysis, including tetraplegia/quadriplegia, and paraplegia
Difficulty breathing; the need to be on a respirator
Problems with bladder and bowel function
Frequent infections; the likelihood of this increases if you are on a feeding or breathing tube
Bedsores
Chronic pain
Headaches
Changes in mood or personality
Loss of libido or sexual function
Loss of fertility
Nerve pain
Chronic muscle pain
Pneumonia (more than half of cervical spinal cord injury survivors struggle with bouts of pneumonia)

SCI Diagnosis

Doctors usually decide to assess patients for spinal cord injuries based on two factors: the location and type of injury a patient has sustained, and his or her symptoms. Anyone who has fallen, suffered a blow, or lost consciousness may have suffered a spinal cord injury. If you also experience headaches, loss of movement, tingling, difficulty moving, or difficulty breathing, your doctor may decide to assess you for a spinal cord injury.

No single test can assess all spinal cord injuries. Instead, doctors rely on a variety of protocols, including:

Clinical evaluation: Your doctor will make a detailed list of all of your symptoms, and may conduct blood tests, ask you to move your limbs, follow movement in your eyes, and conduct other tests to narrow down your symptoms.
Imaging tests: Your doctor may order MRI imaging or other forms of radiological imaging to view your spinal column, spinal cord, and brain.

Leading Causes of Spinal Cord Injuries, Explained

Most spinal cord injuries are preventable, and knowing the causes of these injuries can help you avoid becoming a victim. And if you or someone you love already deal with the frustration and pain of a spinal cord injury, knowing the most common sources of these injuries can help you feel a bit less alone.

The National Spinal Cord Injury Statistical Center at the University of Alabama-Birmingham conducts annual spinal cord injury research, including an assortment of statistics on SCI injuries. It's interesting to note that, in almost all categories of injuries, men are more likely to be injured than women.

In 2014, the most recent year for which statistics are available, the 10 leading causes of spinal cord injuries, and their percentage of the total number of injuries, were as follows:

Auto Accidents: Nationwide, car accidents claim more than 32,000 lives annually. Unsurprisingly, then, car accidents are the leading cause of spinal cord injuries, accounting for 7,205 (29.3%) male injuries and 2,402 (48.3%) female injuries in 2014. Find out what to do after a car accident.
Falls: Falls were the second-leading cause of SCI in 2014, accounting for 5,406 (22%) of male injuries and 1,262 (21.5%) of female injuries.
Gunshot Wounds: Gun-related injuries accounted for 4,163 (16.9%) of male SCIs in 2014, and 572 (9.1%) of female injuries.
Diving Injuries: Propelling head first into the water is an inherently dangerous activity. 1,718 (7%) men suffered spinal cord injuries due to diving accidents in 2014, with 122 (2.1%) female divers experiencing an SCI.
Motorcycle Accidents: The lack of external protection means that even minor motorcycle collisions can be deadly. In 2014, 1,695 (6.9%) men suffered spinal cord injuries while on motorcycles, with a mere 145 (2.5%) women experiencing such injuries.
Falling Objects: Those in industries where falling objects are common are especially vulnerable. 822 men (3.3%) and 37 women (.6%) experienced spinal cord injuries due to falling objects in 2014.
Medical and Surgical Complications: Choosing the right doctor, and carefully monitoring any unusual symptoms can help you avoid a medically induced SCI. 537 (2.2%) men suffered spinal cord injuries due to medical complications in 2014.
Pedestrian Injuries: Ample research suggests that pedestrians are often distracted by phones and other devices, and many such pedestrians are in denial about the extent of their distraction. In 2014, 357 (1.5%) men suffered pedestrian-related spinal cord injuries, with 131 women (2.2%) meeting a similar fate.
Bicycle Accidents: Helmets save lives. Over time, fatal bicycle accidents have generally declined, suggesting that helmet laws are working to keep cyclists safe. Nevertheless, 409 men (1.7%) and 49 women (.8%) suffered bicycling-related spinal cord injuries in 2014.
Other SCI Injury Causes:
- Unclassified, which includes injuries that don't fit neatly into a single category, or for which adequate data is not available.
- Penetrating wounds, such as an object entering the brain or spinal cord.
- All-terrain vehicle (ATV) accidents.
- Accidents in other vehicles, such as jet skis and boats.
- Snow skiing.
- Football.
- Winter sports such as snowboarding.
- Horseback riding.
- Surfing, including body surfing.
- Other sports-related injuries.

SCI Treatment

Unlike with many other injuries, the most important component of spinal cord injury treatment begins before you even get to the doctor. Remaining still, avoiding moving your spinal column, and prompt emergency care, can all increase the odds that you survive, while minimizing the long-term effects of your injury.

From there, doctors will focus on stabilizing you, since the first hours after a spinal cord injury are critical to a patient's survival. Assistance with breathing, a collar to keep your neck still, blood transfusions, and other procedures to address your immediate symptoms may be necessary.

Your doctor will work with you and your family to construct a detailed plan for your SCI rehabilitation. Every injury is different, but common treatments for a spinal cord injury may involve:

Healthier diet and lifestyle helps treat Spinal Cord Injuries

Care to address, but not treat, your immediate symptoms. For instance, a ventilator can help you breathe and a feeding tube can help you eat if you are unable to do so.
Palliative care to help you be more comfortable. If you struggle with insomnia or chronic pain, your doctor might prescribe medication to help.
Lifestyle changes, such as a healthier diet or giving up smoking.
Physical therapy to help retrain your brain and body; many spinal cord injury survivors are able to regain significant mobility with physical therapy.
Family and individual counseling to help you cope with the pain and stress of life with a spinal cord injury.
Surgery as needed to correct injury-related health problems.

Spinal cord injury research is always looking for breakthroughs in treatments, such as stem cell therapy for SCI. Stem cell therapies have long been marketed as a holy grail for a range of diseases, including spinal cord injuries. Recent data suggests that further research could point toward a cure for spinal cord injuries.

Exercises For After a Spinal Cord Injury

Particularly in the early days after a spinal cord injury, you might be tempted to languish in bed. Moving around certainly seems counter intuitive when you've suffered a catastrophic injury to your body. But the benefits of exercise don't disappear just because you've been injured. Quite the contrary, in fact.

Exercises after a spinal cord injury can expedite your SCI rehabilitation in addition to offering a myriad of health benefits.

Exercises:

Yoga: ideal for spinal cord injury survivors because the gentle stretching encourages healthy breathing patterns, and can reduce the pain of spending all or most of your day in a wheelchair.
Water Aerobics: The water reduces pain and joint trauma, and can help support your weight even if you've lost a significant portion of your mobility or sensation.
Weightlifting: Lifting weights can help you regain significant muscle control. It will also enable you to maintain strength in regions unaffected by your spinal cord injury.
Seated Aerobics: You can still get an incredible aerobic workout from your wheelchair. Talk to your doctor about seated aerobic classes specifically targeted to spinal cord injury survivors
Rowing: Rowing is an ideal aerobic activity because it only requires movement in your upper body, but uses your lower body to stabilize your movements, making it an ideal choice for injury survivors with incomplete spinal cord injuries.
Walking: If your spinal cord injury is incomplete or you have only sustained nerve damage, you may still be able to walk. Maximize your muscle function by walking as frequently as is comfortable, maintaining a steady gait, and an upright posture.

Exercise benefits:

Improving mental health by reducing depression and anxiety
Reducing the risk of cancer
Improving symptoms of chronic pain
Helping you avoid chronic illnesses such as diabetes and osteoporosis
Reducing your risk of falls
Improving your chances of living a longer life

Spinal Cord Injury Recovery

Your SCI rehabilitation journey can be long and often unpredictable. Some spinal cord injury sufferers spontaneously walk years after their injury. Others are never able to move again. While medical science can do a lot to predict what might happen to you, there are no guarantees when it comes to spinal cord injuries. What we do know is that a healthy lifestyle, sound psychological health, family support, and receiving treatment at a model system of care can all improve outcomes.

Physical Recovery

There is no single definition of physical recovery. Though many spinal cord injury survivors do regain some degree of function, some don’t. Thus, focusing solely on physical recovery can leave you feeling hopeless and overwhelmed.

Some common milestones for physical recovery include:

The reduction of swelling at the site of the injury.
Recovering from surgery.
Regaining some sensation below the site of the injury.
Regaining some movement below the site of the injury.
Learning to use assistive devices such as wheelchairs and prostheses.
Finding new ways to complete old tasks; for instance, you might change your approach to sex or making food.
Strengthening your body so you can work around your injuries. You might learn how to type with a part of your body other than your hands, for instance.

Psychological Recovery

Spinal cord injury guides, as well as doctors, lawyers, and loved ones, often focus on physical recovery. But this dogged fixation can actually undermine your psychological recovery. Poor psychological health can worsen your physical health, and believing that physical recovery is the only way to be happy can likewise undermine your psychological well-being. It is possible to be happy even in the face of a painful injury. Indeed, one study found that 86% of quadriplegics rated their lives as better than average.

This attitude can take some time to cultivate, but once you've mastered it, you may realize an important truth about life: happiness comes from within, and the way you think about things affects the way you perceive them. Spinal cord injuries are challenging, and there is no shame in seeking psychological help. Many survivors struggle with depression, anxiety, and other mental health issues, but with family support and lots of help, you can find new ways to live a life you love.

Spinal Cord Injury Statistics

When you or a loved one struggle with a spinal cord injury, it's easy to feel isolated. Endless fights with insurers, trying to find the right doctor, seeking support from loved ones, and managing your everyday life can prove deeply demoralizing. But spinal cord injuries are common, and you're not alone.

The month of September is Spinal Cord Injury Awareness month and there is a lot that the general public is unaware of about SCIs. Here are some key spinal cord injury statistics from spinal cord injury research. Here are some of the things you need to know to help keep the world a little more informed about the reality of these devastating injuries.

SCI Prevalence

There are approximately 12,500 new spinal cord injuries each year, meaning 40 out of every one million people suffer such an injury.
Between 240,000 and 337,000 Americans currently live with a spinal cord injury.
Incomplete spinal cord injuries are more common than complete injuries, which account for less than 40 percent of all cases.

SCI Demographics

Spinal cord injuries primarily affect young people, with almost half of all injuries occurring among those aged 16 to 30.
80 percent of spinal cord injury survivors are men.
More than half (57 percent) of spinal cord injury survivors are employed at the time of their injury.

SCI Prognosis and Nature

Motor vehicle accidents are the most common cause of spinal cord injuries, accounting for roughly 47 percent of all cases, with falls in second place, accounting for about 21 percent.
88 percent of spinal cord injury survivors who were single at the time of the accident are single five years later, compared to 65 percent in the general population.
Two-thirds of sports-related spinal cord injuries are from diving, making it the most dangerous sport for the brain and spinal cord.

The average hospital stay is around 11 days -- down from about 24 days a few decades ago, and suggesting an improvement in outcomes and quality of care.
Incomplete tetraplegia/quadriplegia is the most common injury, accounting for 45 percent of cases.
15 percent of spinal cord injury survivors are students.
32.7 percent of spinal cord injury survivors are married, and the rate of marriage increases as spinal cord injury survivors age, suggesting that a spinal cord injury doesn't have to mean a life free of romantic relationships.
Depending on the nature of the injury, the cost of the first year of care ranges from $300,000 to about $1 million, and this first year is always the most expensive. Subsequent costs per year range from $40,000 to about $170,000. More severe injuries are generally more costly, with high tetraplegia in C1-C4 producing the highest costs of about $1,023,000.00 during the first year.

SCI Grant Programs & Associations You Should Know

Medical treatment and care immediately following the injury. Ongoing medical care and therapy. A personal care assistant. Prescription costs. Assistive devices. The list of costs after sustaining a traumatic spinal cord injury is seemingly endless, and many people don’t know where to turn for financial assistance.

Thankfully, there are a lot of good people out there who have good hearts. These outstanding individuals have created organizations to help others who find themselves in these types of financial situations. Sometimes, this help comes in the form of grants and scholarships.

Spinal cord injury grants often are earmarked for specific purposes. They typically can be used to cover costs relating to:

Spinal cord injury research;
SCI rehabilitation assistive devices;
Accessible home modifications or renovations;
Academic pursuits; and
Care and ongoing treatment.

Not sure where to begin when trying to find spinal cord injury grants? There are many organizations that exist in the United States that offer those forms of financial assistance.

For your convenience, we’ve put together a list of the top 15 spinal cord injury associations (some offering scholarship and grant programs):

180 Medical: an organization that provides academic scholarships to individuals with a variety of medical conditions so they can pursue their dreams of earning higher degrees.

*Has a scholarship program

American Spinal Injury Association (ASIA): This association establishes standards for all aspects of spinal cord injury treatment. Their website has a number of sections from which you can develop your knowledge of these sorts of injuries called the learning center.
FacingDisability: This website was put together by a survivor of a tragic personal accident to form a safe, welcoming, and informative platform for people with spinal cord injuries, as well as their friends and family members.

Foundation for Spinal Cord Injury Prevention, Care, and Cure: Use this website to find free resources for SCI sufferers and their families, which include support groups, home care supplies, and disability law advice.
Grants.Gov: A government resource is an incredible tool for helping spinal cord injury survivors and researchers locate government-backed grants.

*Has a grant program

Gridiron Heroes: A non-profit organization that provides short- and long-term assistance to individuals who sustained traumatic spinal cord injuries relating to high school football.

*Has a grant program

Help Hope Live: Great resource for individuals with spinal cord injuries who are interested in fundraising and crowdfunding.

Kelly Brush Foundation: Having raised more than $4.5 million, the organization has provided grants to buy adaptive sports equipment, such as monoskis, handcycles and sports chairs for people with spinal cord injuries in 47 states.

*Has a grant program

Paralyzed Veterans of America: A non-profit organization that provides research grants for projects that seek to achieve groundbreaking spinal cord injury research toward finding a cure for paralysis and other conditions that result from SCI injuries or diseases.

*Has a grant program

Rick Hansen Foundation: Established in 1988, this foundation continues to raise awareness and money to build a better future and a world without barriers for people with disabilities. Although not specifically aimed at those with a spinal cord injury, it remains a great source of advice and information.
Spinal Cord Opportunities for Rehabilitation Endowment: (SCORE) is an organization that aims to provide spinal cord injury survivors with the financial assistance to improve their quality of life.

*Has a grant program

The Christopher and Dana Reeve Foundation: Provides updates on new financial assistance programs and also offers grants of its own. Its Quality of Life grant program provides funding to non-profit organizations that serve to benefit people with disabilities and their families.

*Has a grant program

The Cindy Donald Dreams of Recovery Foundation: A nonprofit that provides spinal cord injury grants to individuals to help cover the costs of assistive medical devices, physical and occupational therapy, and other forms of treatment and assistance.

*Has a grant program

Travis Roy Foundation: A well-known organization that provides funding to spinal cord injury research initiatives. Since its inception in 1997, the foundation has provided assistive devices to paraplegic and quadriplegic individuals with spinal cord injuries via quality of life grants.

*Has a grant program

United Spinal Association: This resource center is a great place to speak to others and share your journey by learning from one the experiences of others. Their support group is not only a crucial part of the website, but they offer information about grants, advertise events, not to mention share a host of educational publications.

Spinal Cord Injury Types

Spinal Cord Anatomy: The Basics

Spinal Cord Injury Types

Complete Spinal Cord Injuries

Incomplete Spinal Cord Injuries

Spinal Cord Injury Symptoms

SCI Diagnosis

Leading Causes of Spinal Cord Injuries, Explained

SCI Treatment

Exercises For After a Spinal Cord Injury

Spinal Cord Injury Recovery

Physical Recovery

Psychological Recovery

Spinal Cord Injury Statistics

SCI Prevalence

SCI Demographics

SCI Prognosis and Nature

SCI Grant Programs & Associations You Should Know

Spinal Cord Injury

Brain Injury

Finding Treatment

Legal Options

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