If you or a loved one has sustained a spinal cord injury, you’ve most likely heard the doctor or medical team classify the injury with a letter and number, such as C-4 or T-2. These letters and numbers refer to the levels of function a spinal cord injury survivor has after the injury.
Function of Spinal Cord, and Impact of Injury
The human spinal cord acts as a conduit between the brain and the rest of the body, relaying messages. When the spinal cord is bruised, crushed, or torn, the messages sent between the brain and the body no longer flow through the damaged area of the spinal cord.
The functions of the body located above the point of injury will continue to operate normally, while the functions below the point of injury will suffer some degree of impairment, including motor deficit, sensory deficit, bowel and bladder dysfunction, and respiratory difficulties.
C-level injuries occur at the cervical area of the spine. An injury that occurs in the C-1 to C-3 area results in limited movement of the head and neck only, with paralysis below that region. In many cases, survivors of C-1 to C-3 injuries have difficulty talking, and require the use of a ventilator to breathe.
Survivors with C-3 to C-4 injuries have head and neck movement, as well as some limited shoulder movement. They are typically able to talk, and can eventually adjust to breathing without a ventilator.
Those with C-5 level injuries generally have head, neck, and shoulder control, and can bend the elbows and rotate their hands. At this level, self care is manageable.
A C-6 level injury results in movement of the head, neck, shoulders, arms, and wrists, including the ability to bend the elbows, extend the wrists, and rotate palms. The population who falls into this category is generally able to perform most independent activities. Those with C-7 injuries have similar abilities as those with C-6 injuries, but can manage more easily.
Injuries that occur at the T-level of the spinal cord occur in the thoracic region of the spine. Those with C-8 to T-1 level injury will be able to use their upper body, including fingers.
Survivors with T-2 to T-6 have normal function in the upper body, but have some degree of impairment in the legs. Those with T-7 to T-12 level injuries have similar function, with slightly more control.
L-level injuries occur in the lumbar region of the spine, and survivors generally have some ability to move the hips and knees. With this type of injury, walking is often possible with assistive devices.