Spinal Cord Injury Levels

Spinal Injury Level Sections

C1 - C3 : C4 : C5 : C6 : C7 - C8 : T1 - T4 : T5 - T9 : T10 - L1 : L2 - S5

Spinal Nerves and Levels

Spinal cord injury levels are used to explain the different severities of paralysis following an injury to the spinal cord. Generally, the higher the level of injury to the spinal cord the greater the degree of paralysis will result. The image on the right shows the vertebra from which the spinal nerve exits above or below the spinal segment. In the cervical vertebrae the spinal nerves exit the spinal column above the vertebra, except for C8 which exits below the 7th cervical vertebra. From T1 downwards all spinal nerves exit the spinal column below their corresponding vertebra.

In order to help understand how the level of spinal cord injury affects a persons mobility, the following spinal cord injury level guide has been produced. This is only a general guide and because every spinal cord injury is different, there may be variations in functional ability from person to person.

Complete and Incomplete Spinal Cord Injuries

Spinal cord injuries are categorised as two types of injury:

  • A complete spinal cord injury.
  • An incomplete spinal cord injury.

A complete spinal cord injury means that there is no function or sensation below the level of the injury

An incomplete spinal cord injury means that there is some function or sensation below the primary level of the injury. A person with an incomplete injury may be able to move one limb more than another, may be able to feel parts of the body that cannot be moved, or may have more functioning on one side of the body than the other.

The American Spinal Cord Injury Association - ASIA Impairment Scale

In order to help classify differing degrees of spinal cord injury, the ASIA impairment scale is used to help compare and understand residual function.

  • A - Complete: No motor or sensory function in the lowest sacral segment (S4-S5)
  • B - Incomplete: Sensory function below neurological level and in S4-S5, no motor function below neurological level
  • C - Incomplete: Motor function is preserved below neurological level and more than half of the key muscle groups below neurological level have a muscle grade less than 3.
  • D - Incomplete: Motor function is preserved below neurological level and at least half of the key muscle groups below neurological level have a muscle grade 3.
  • E - Normal: Sensory and motor function is normal

Functionality of C1, C2, C3 Quadriplegic

Mobility & Movement

Limited head and neck movement depending on muscle strength.

Complete paralysis of arms, body and legs.

Sympathetic nervous system will be compromised, possibility of autonomic dysreflexia.

Electric wheelchair may possibly be controlled by either a chin or "sip and puff" controller, this will vary depending on dexterity.

The person will require total assistance when transferring from a bed to a wheelchair and from a wheelchair into a car. A hoist will have to be used, possibly by two assistants for safety.

Complete assistance required during mealtimes.

Respiratory System

Inability to breathe using chest muscles or diaphragm, therefore the person will be dependant on a ventilator to breathe. A portable ventilator can be attached to the back of a wheelchair during transport.

Oxygen and humidification may be required.

Assistance required to clear secretions from trachea, and assistance in coughing will be required.

Personal Care

Complete personal assistance is required. The person will need assistance with washing, dressing, and assistance with bowel and bladder management.

Domestic Care

Complete domestic care is required, such as household cleaning, washing of clothes and kitchen duties, preparation of meals and general household duties.


A computer may be operated using iris recognition, mouth stick or voice recognition. Telephone can be used using voice recognition and headset.

The above functionality guide is only a general guide. Abilities will vary depending on the persons weight, existing medical conditions and age.