High-Cervical Nerves (C1 – C4)

• Most severe of the spinal cord injury levels
• Paralysis in arms, hands, trunk and legs
• Patient may not be able to breathe on his or her own, cough, or control bowel or bladder movements.
• Ability to speak is sometimes impaired or reduced.
• When all four limbs are affected, this is called tetraplegia or quadriplegia.
• Requires complete assistance with activities of daily living, such as eating, dressing, bathing, and getting in or out of bed
• May be able to use powered wheelchairs with special controls to move around on their own
• Will not be able to drive a car on their own
• Requires 24-hour-a-day personal care

Low-Cervical Nerves (C5 – C8)

• Corresponding nerves control arms and hands.
• A person with this level of injury may be able to breathe on their own and speak normally.

• C5 injury

  • Person can raise his or her arms and bend elbows.
  • Likely to have some or total paralysis of wrists, hands, trunk and legs
  • Can speak and use diaphragm, but breathing will be weakened
  • Will need assistance with most activities of daily living, but once in a power wheelchair, can move from one place to another independently

• C6 injury

  • Nerves affect wrist extension.
  • Paralysis in hands, trunk and legs, typically
  • Should be able to bend wrists back
  • Can speak and use diaphragm, but breathing will be weakened
  • Can move in and out of wheelchair and bed with assistive equipment
  • May also be able to drive an adapted vehicle
  • Little or no voluntary control of bowel or bladder, but may be able to manage on their own with special equipment

• C7 injury

  • Nerves control elbow extension and some finger extension.
  • Most can straighten their arm and have normal movement of their shoulders.
  • Can do most activities of daily living by themselves, but may need assistance with more difficult tasks
  • May also be able to drive an adapted vehicle
  • Little or no voluntary control of bowel or bladder, but may be able to manage on their own with special equipment

• C8 injury

  • Nerves control some hand movement.
  • Should be able to grasp and release objects
  • Can do most activities of daily living by themselves, but may need assistance with more difficult tasks
  • May also be able to drive an adapted vehicle
  • Little or no voluntary control of bowel or bladder, but may be able to manage on their own with special equipment

Thoracic Nerves (T1 – T5)

• Corresponding nerves affect muscles, upper chest, mid-back and abdominal muscles.
• Arm and hand function is usually normal.
• Injuries usually affect the trunk and legs(also known as paraplegia).
• Most likely use a manual wheelchair
• Can learn to drive a modified car
• Can stand in a standing frame, while others may walk with braces

Thoracic Nerves (T6 – T12)

• Nerves affect muscles of the trunk (abdominal and back muscles) depending on the level of injury.
• Usually results in paraplegia
• Normal upper-body movement
• Fair to good ability to control and balance trunk while in the seated position
• Should be able to cough productively (if abdominal muscles are intact)
• Little or no voluntary control of bowel or bladder but can manage on their own with special equipment
• Most likely use a manual wheelchair
• Can learn to drive a modified car
• Some can stand in a standing frame, while others may walk with braces.