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After a spinal cord injury, you’ll start to hear a lot of new vocabulary - terms and phrases that are used to classify and describe a specific injury. Spinal cord injury classification is intricate and may be overwhelming at first, but this module will help familiarize you with some of this new terminology and how it’s used.

A spinal cord injury, often abbreviated as SCI, occurs when the spinal cord is damaged and communication is disrupted between the brain and the rest of the body. Typically, some degree of paralysis, whether temporary or permanent, is experienced in the body below the level of the injury.

The spinal cord starts at the base of your brain and runs through rings of bone called vertebrae down your neck and back. The vertebrae are numbered in four grouped sections based on their location: Cervical, Thoracic, Lumbar and Sacral. The spot where the spinal cord injury occurs is referred to by the nearest vertebra(e).

Each section of the spinal column is abbreviated to the first letter - C for Cervical, T for Thoracic, L for Lumbar, and S for Sacral. Each section has a set number of vertebrae that are counted from the top down. For example, someone who is classified as a T4 has an injury in the thoracic area at the fourth vertebra down, and his or her function will typically be affected from about the chest level downward. If more than one vertebra is affected, they are all included. For example, a C6-7 injury means that both the 6th and 7th vertebrae in the Cervical section were affected.

The following image shows the vertebrae in the spinal column and which parts of the body are affected by an injury in those areas.

an image of the human body color coded to reflect different levels of the spinal cord injury
Image source:

In addition to having a “level” of injury based on the vertebra(e) affected, doctors will also typically diagnose a “degree” of the injury based more or less on how much the spinal cord was damaged. This may range from the cord being bruised to completely severed or other impacts.

There are a few ways this is described:

Complete injury: a spinal cord injury where there is no function or sensation below the level of injury. This is typically associated with more severe damage of the spinal cord itself.

Incomplete injury: a spinal cord injury where there is some function or sensation below the level of injury. Injuries labeled in this way typically have less damage to the spinal cord than a complete injury.

ASIA/ISCoS Exam and Grade: The American Spinal Injury Association / International Spinal Cord Society or ASIA/ISCoS exam is usually administered within 72 hours of an injury in order for the medical team to determine the severity of a spinal cord injury. The grade is based on the patient’s level of sensation and function in affected parts of the body. The scale ranges from the letters A through E. An A grade is designated as a complete injury the most severe damage. Grades B, C, and D are incomplete injuries with varying sensation and function moving towards an E grade, which means no impairments in sensation or function.

Keep in mind that no two injuries are the same. While you may get a certain diagnosis, it’s possible the grade may change or you may have outcomes that are less common.

Typically following a spinal cord injury, the individual is diagnosed with one of two labels based on the mobility of the four limbs (two arms and two legs):

Paraplegia: a spinal cord injury in the thoracic, lumbar, or sacral area of the spine. This is for people who only have two limbs affected, their legs, and have full mobility of their arms and fingers. A person with paraplegia is often referred to as a paraplegic.

Quadriplegia: a spinal cord injury in the cervical area of the spine. This is for people who have all four limbs affected, even if there is still some mobility in any of the limbs. A person with quadriplegia is often referred to as a quadriplegic. You might also hear this referred to as tetraplegia. 

an image of a body with the levels of the spinal cord labeled with explanations
Image source:

With this information, you should now be able to understand a spinal cord injury diagnosis.

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Information is for informational purposes only and is not to be considered medical advice. Consult your physician or qualified health care provider before acting or relying on anything depicted on this website.