C1-C7 Level of Spinal Cord Injury

C-1 to C-3:
An injury that occurs in the C-1 to C-3 area results in limited movement of the head and neck, 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.

C-3 to C-4:
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.
C-5:
People with spinal cord injuries that occur at the C-5 level often have head, neck, and shoulder control, and can bend the elbows and rotate the hands. This is the level at which self-care and management becomes possible. Survivors with C-5 injuries are usually able to push their own wheelchairs, and can also be taught to drive a car with adaptive equipment.
C-6 to C-7:

Survivors with injuries at the C-6 to C-7 levels can move their heads, necks, shoulders, arms, and wrists. They can also bend the elbows, extend the wrists, and rotate their hands. Most self-care is possible for people who fall into this category, as is driving, managing a manual wheelchair, and housekeeping.

Early Treatment for Spinal Cord Injury

Spinal cord treatment is divided into two phases—the acute phase and the rehabilitation phase. The acute phase starts immediately following the accident, and comprises the care that is received at the scene of the accident, the care that is administered upon admission to the hospital, and all subsequent care prior to the survivor entering the rehabilitation phase.
During the time immediately following the injury, the goal of the medical team is to stabilize the patient to ensure that no further damage to the spinal cord is sustained. Doctors are particularly concerned with reducing or minimizing swelling, as this can cause even more extensive damage to the spinal cord. Other treatment during this phase includes a combination of medication, surgery, bed rest, traction, and immobilization.
Immediately upon arriving at the hospital, the medical team will usually give the survivor a strong course of a steroid called methylprednisone (MP), which is designed to reduce swelling. The key is for this drug to be administered within eight hours of the injury. This will minimize the chances of further damage being done to the spinal cord as a result of swelling. In cases where bone fragments or foreign objects are pressing on the spine and causing additional swelling, surgery to remove these objects will be done.
Bed rest is a very important part of the acute care phase, because it allows the bones of the spine, which bear the majority of the body’s weight, to heal. Spinal traction may also be used to immobilize the spine and prevent dislocation. Sometimes the skull is immobilized with special equipment, allowing the spine to realign during the healing phase.
During the acute phase, the medical team may also indicate that the patient is experiencing something called “spinal shock.” Spinal shock is a condition that causes the survivor’s reflexes not to work, as a result of the trauma the spine has sustained. During the time the survivor is experiencing spinal shock, doctors may be hesitant to discuss long-term prognosis. That’s because it’s very difficult to accurately separate the loss of function that has resulted from the injury from the loss of function that’s occurring as a result of spinal shock. In most cases some function beyond what is seen during the spinal shock stage will return to the survivor.
When all is said and done, the goal during the acute phase is to stabilize the patient and minimize the amount of damage done to the spinal cord. Once the patient has stabilized, he or she will enter into the rehabilitative phase of care.
How do we know the hospital is equipped and knowledgeable to deal with a spinal cord injury?
Family members won’t have time to be choosy about where their loved one is taken, but they can rest assured that they’ll be taken to a hospital that has the experience and ability to handle the acute phase of spinal cord injury.

The main goal of the emergency response team—the group that arrives upon the scene of the accident—is to get the injured person to the nearest Brain and Spinal Cord Injury Program (BSCIP) designated facility. BSCIP-designated hospitals must meet certain standards and criteria set forth by the Department of Health, and must also be approved by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Any hospital that has been designated with the BSCIP label has the experience, personnel, and equipment necessary to see that the patient receives the best care possible. BSCIP-designated facilities are located throughout the country, in a pattern that ensures that every person who sustains a spinal cord injury is able to reach one in a reasonable amount of time.

Exercises for Spinal Cord Injuries

Spinal cord injury can occur to any area of the spine, including the cervical, thoracic or lumbar areas or the neck, chest or lower back. Where the injury occurs will determine what symptoms or loss of function a person experiences. For example, a person with a cervical spinal column fracture may experience loss of function below the neck, or he may heal with complete recovery of his body. The type, severity and prognosis for spinal cord injuries determine the physical therapy or exercise approach for each individual patient.

Spinal Cord Injuries
Spinal cord injuries almost always cause some kind of loss of function below the site of the injury, according to the National Center on Physical Activity and Disability. Spinal cord injuries are considered to be complete or incomplete, meaning that partial or temporary damage to the spinal cord, or as in the case of complete injury, severe and sometimes permanent damage to the spinal cord. The cervical spinal cord is made up of 8 vertebrae, while the thoracic is made up of 12, the lumbar 5 and the sacral area 5 vertebral bone structures that allow for movement and flexibility while at the same time protecting the spinal cord from injury. A number of exercise approaches may be appropriate, depending on the location, extent and severity of damage to the spinal column or cord.
Exercises for Spinal Cord Injuries
Several types of exercises are generally incorporated into an exercise program for someone who's experienced a spinal cord injury, according to the National Center on Physical Activity and Disability. These exercises can include but are not limited to cardiovascular, weight or strength training and aerobic conditioning, all of which can be adapted by physical therapists for those in wheelchairs. Range of motion exercises as well as stretching and balancing exercises help promote muscle and joint health and flexibility.
Exercising helps prevent atrophy of muscle tissues, though some atrophy or loss of muscle mass usually occurs following inactivity caused by conditions like paralysis. Exercise and movement also encourages circulation of nutrients and blood to all areas of the body, helps prevent bed sores or decubitous ulcers and promotes movement, independence and adaptive mobility to those experiencing partial paralysis. Physical therapy and exercise begun as soon as swelling surrounding a spinal cord fracture is reduced may promote healing and some or complete restored function to areas of the body affected by the spinal cord injury.

Passive range of motion exercises can be done by a physical therapist or other care provider to gently move or rotate a person's joints in order to maintain mobility, range of motion, and prevent contractures. Range of motion exercises help promote circulation and help keep joints flexible, though this type of exercise doesn't make muscles stronger, according to Drugs.com.

C-1 to C-4 Spinal Cord Injury

These extremely high injuries can result in either complete or incomplete quadriplegia/tetraplegia, in which the voluntary movement and sensation in all four limbs are compromised. While the patient is completely paralyzed, some function may be retained depending upon the exact location of the injury.

Complete and Incomplete Spinal Cord Injuries
C-1 to C-4 injuries can be classified as either complete or incomplete injuries. Complete injuries result in the total loss of movement and sensation below the point of injury, while incomplete injuries indicate that some function below the level of injury is retained.
Effects of C-1 to C-4  Spinal Cord Injuries
Patients with C-1 to C-4 spinal cord injuries generally use diaphragm function and require a ventilator to breathe. Other complications may include:
Bowel and bladder dysfunction
Sexual dysfunction
Difficulty regulating heart rate, blood pressure, sweating, and body temperature
Spasticity
Neuropathic pain
Muscle atrophy
Osteoporosis
Gallbladder and renal stones
Treatment for C-1 to C-4  Spinal Cord Injuries

Immediate medical intervention following the injury will increase the likelihood of the best possible long-term prognosis. In most cases, the acute stage of injury is followed by extensive rehabilitation, which is designed to help the survivor adapt both physically and mentally to his or her new condition. While their lives will certainly be different than they were before the injury, with the correct intervention and support, survivors with C-1 to C-4 injuries can go on to lead very fulfilling lives. In the meantime, scientists continue to study treatments for spinal cord injury, designed to both reduce the effect of the injury and promote the growth of functional nerve fibers.

Level of Spinal Cord Injury

Level of Spinal Cord Injury
As many as 400,000 Americans are living with spinal cord injuries. Most spinal cord injuries occur between the ages of 16 and 30, and about 82 percent of those who experience spinal cord injuries are male. Motor vehicle accidents account for approximately 44 percent of all spinal cord injuries.

Doctors and specialists use the level of injury to most accurately predict which parts of the body are most likely to be affected by loss of movement and sensation. Complete injuries will result in total loss of movement and sensation below the point of injury, while incomplete injuries will result in some degree of loss of movement and sensation below the point of injury. Levels of injury are classified as:
Neck
C-1 to C-4
C-5
C-6
C-7 and T-1
T-1 to T-8

T-9 to T-12

Medicine Treatment For Spinal Cord Injury

Each year around 12,000 people in the United States suffer a spinal cord injury. The medical costs of a spinal cord injury can be staggering. The costs depend on the severity of the injury and the length of stay in the hospital and rehab.
An average hospital stay for SCI is around 12 days and the average inpatient rehabilitation stay is around 37 days. Because of medical improvements these figures are much lower than the rates in the early 1970s, when a rehab stay for SCI was often longer than 90 days.
Expenses for an SCI include: initial hospitalization, rehabilitation, and most likely the continuing need for a caregiver and medical care. A person who suffers high tetraplegia, the most severe form of SCI, may acquire medical expenses of over $800,000 in the first year after the injury. If this person is 25 years old or younger their medical expenses may mount up to over $3 million over their lifetime. People 50 years old or older at the time of a severe SCI may expect medical expenses of over $1.8 million over the course of their lifetime. SCI survivors with less disabling injuries face lower, but still hefty medical bills.
Insurance which may cover Spinal cord injury
If you or a family member has suffered a spinal cord injury the insurance company of the party responsible for the accident which caused your injury or your insurance may pay some of your medical bills. The amount of coverage depends on the policy and on the circumstances of the accident. Often, the insurance company of the party responsible for the injury will not pay a sufficient amount of damages for the injury; this makes it vital to obtain advice from an experienced brain injury attorney. Lawyers experienced in advocating for SCI survivors know how to get just financial compensation for you.
Health and Accident Insurance

These policies vary considerably. Some only pay only for injuries from accidents and natural disasters; others offer more coverage, including, routine doctor visits and annual physicals, as well as coverage for tests, and hospital stays for illness and injuries. Insurance polices are usually written in complicated legal terms, making them difficult to understand; talk with someone from your insurance company when an accident occurs so that you know what they will cover. Homeowner’s insurance may offer some coverage when an accident which results in a spinal cord injury occurs at home; this insurance also generally offers some coverage when someone else is injured in your home. About 26 percent of spinal cord injuries are the result of falls and many falls occur at home.

Foods to Avoid for Spinal Cord Injury Patients

After a spinal cord injury, a person's metabolism often changes significantly. Because they use fewer muscles, people with a spinal cord injury require fewer calories per day. However, if their eating habits do not change after their injury, they may be at risk for obesity and other related health conditions. Avoiding certain types of food after a spinal cord injury can help a person maintain a healthy weight.

Fast Foods
Fast foods are high on the list of foods to avoid after a spinal cord injury, or SCI, as they tend to pack excessive calories into a single meal. The Spinal Cord Injury Network reports that the average fast food meal contains around 1,200 calories. For some people, this may be half of their entire daily recommendation after their spinal cord injury.
Clearinghouse, a person with a spinal cord injury usually requires around 10 percent fewer calories per day than the average person. They may need even less if they are severely impaired or inactive. Avoiding fast foods can help a person reduce his caloric intake, as well as avoid the excess fat, cholesterol and sodium that these foods tend to contain.
High-Sodium Foods
The Spinal Cord Injury Network recommends people with paraplegia or quadriplegia limit their sodium intake to between 500 and 1,000 mg daily. More than this amount may cause excess fluid retention, which can leave their bodies more vulnerable to related health conditions. Excess sodium can raise blood pressure, a risk factor for heart disease and stroke. Sodium is found not only in salt but also in many sauces, condiments and pre-made meals. Reading labels and avoiding high-sodium foods can help people living with SCI reduce their risk of heart attack and stroke.
Alcoholic Beverages

Alcohol is another empty calorie beverage, which not only adds to the daily calorie count without adding any nutrition but has other potential side effects as well. Alcohol can have an increased effect for someone with a spinal cord injury; because of this, daily consumption should be limited. Baylor recommends one drink per day for women with SCI and two for men with SCI as a maximum.

What is Spinal Cord Injury

A spinal cord injury (SCI) refers to any injury to the spinal cord that is caused by trauma instead of disease. Depending on where the spinal cord and nerve roots are damaged, the symptoms can vary widely, from pain to paralysis to incontinence. Spinal cord injuries are described at various levels of “incomplete”, which can vary from having no effect on the patient to a “complete” injury which means a total loss of function.
Treatment of spinal cord injuries starts with restraining the spine and controlling inflammation to prevent further damage. The actual treatment can vary widely depending on the location and extent of the injury. In many cases, spinal cord injuries require substantial physical therapy and rehabilitation, especially if the patient’s injury interferes with activities of daily life.

Spinal cord injuries have many causes, but are typically associated with major trauma from motor vehicle accidents,falls, sports injuries, and violence. Research into treatments for spinal cord injuries includes controlled hypothermiaand stem cells, though many treatments have not been studied thoroughly and very little new research has been implemented in standard care.

Nursing Care Plan for a Spinal Cord Injury

A spinal cord injury can be a very serious condition that requires around-the-clock care for the patient. As a nurse, it's your job not only to make sure the patient is receiving any treatments, medications, or tests the doctor orders; it's also your job to see that the patient is comfortable, that he is taken care of mentally and emotionally as well. The complexity of a spinal cord injury requires you to pay close attention to every detail the patient tells you about or that you observe, so that you can report any problems or complications to the doctor in charge.

If you work in the emergency department of the hospital, you will, at some point, have a patient come in with a spinal cord injury. In order for the patient's prognosis to be the best that it can be, you must work very closely with the doctors and other nurses to make sure that several things don't happen. For instance, the patient's head and neck need to be stabilized to ensure that he doesn't receive even more injury; it may be necessary for you to place the patient into traction. He may need help breathing also, depending on the severity of his injury. Keep him as still as possible, administering sedatives, if ordered, to allow for less movement or irritation during tests and treatments; you must also monitor his oxygen intake as well. Other things the doctor may order are the placement of a catheter, so as to allow the patient to be rid of wastes and not have it sitting in his bladder. Vital signs will also need to be monitored very closely, as the patient could develop cardiovascular signs of distress or blood clots. The doctor may order a medication called Medrol to be given to the patient, and this needs to be done right away to possibly minimize damage done to the spinal cord. Of course, keeping the charts carefully updated is always a must, as this keeps the doctors and other nurses who come in at different shifts updated and aware of any history or potential complications.
The patient will most likely be admitted to the hospital to stay for several days or even weeks. If he is not able to move below a certain point, he may be at risk for certain complications. You will need to keep monitoring his cardiovascular and respiratory health, especially watching for blood clots, as immobilization drastically increases the risk for these. He may need exercises called range-of-motion exercises to keep his arms and legs from losing the muscle and to keep them from becoming flaccid and cramped. Make sure the patient is turned or moved to a different position every two hours so that the risk for pressure ulcers can be minimized; examine his skin every eight hours. The patient's input and output need to be charted; that way if signs of retention show up, something can be done to help the patient. You must give all medications that are ordered and chart that they were given. Again, charting is crucial at this point to show the patient's progress and history.
As the patient improves, he may be transferred to a rehabilitation facility to recover and learn how to live with his injury. As a nurse in the rehab center, you may have several jobs. Most rehab involves therapists and physical therapists, but you will be monitoring the patient's health overall, and you may assist with certain things. You will help the patient in his recovery process by encouraging him to go to every session with the physical therapist, as this will speed his recovery. While there, he will be working not only with movement and strength training, but he will be learning how to live with his injury, such as using a wheelchair. He'll be relearning even the simplest tasks because he will have to do them in a different way now. You will also need to teach the patient about certain physical aspects of his injury and things that he might expect when he gets home. He may need to be taught how to use a catheter; he may need teaching on UTI's and taking care of his skin, as well as making sure his home is ready for him when he gets there.

Through all of the added stress that a spinal cord injury produces, your patient will need you sometimes to just be there as his nurse. He will need encouragement and all the help you can muster from the beginning. He's going to probably go through a grieving process, as he feels he's lost a part of his life that he might never regain. He may have problems coping. As his nurse, you need to make sure that you communicate effectively with him; study and research his injury, so that you fully understand what is going on with him physically. This will allow for much better communication with the patient. Be honest and upfront with him; don't sugarcoat any detail because this could lead to distrust later on. Most importantly, listen to the patient. He just needs a listening ear at this point. As he improves and starts gaining ability to do certain things on his own, encourage him and praise him, as this will improve his emotional well-being overall and could spur him to keep going and not to give up. Get to know your patient and what he likes or dislikes. If you are going to administer a treatment, tell the patient what you are doing in full detail, so that he understands what to expect. If the patient gets bored, which is very possible with immobilization, find interesting things for him to do, based on what you've learned about him, by getting to know him. Lastly, watch for and report any signs of psychological distress in the patient, so that if the need arises, he can be seen by a social worker or therapist.

Rehabilitation for T12 Spinal Cord Injuries

Spinal cord injuries below T12 affect your lower back, anal sphincter muscle and may damage your defecation reflux. Such injuries can range from mild to severe. Exercise, a good mental outlook and activity play important roles in recovering from a spinal cord injury by managing and/or reducing symptoms, lowering the risks of constipation and promoting more efficient bowel programs. Rehabilitation for spinal cord injuries below T12 should concentrate on returning you and your spine to a healthier functioning level. Always check with your doctor before beginning any exercise or therapy program.

Abdominal Massaging
Massage can play a role in rehabilitation for spinal cord injuries below T12. Performing an external massage, using circular motions, can increase bowel activity, notes the University of Washington Rehabilitation Medicine Department. Lie on your back on a comfortable surface, such as a bed or sofa. Fully extend your legs. Place your right hand on your lower abdomen. Gently apply pressure and start massaging in a clockwise circular motion. Start at your right side and keep making circles until you reach your left abdominal side. Stop the massage and relax for 30 seconds. Repeat this exercise by making counterclockwise circular motions from your left to your right side.
Rehabilitation for spinal cord injuries below the T12 sometimes can benefit from gentle aerobics. Aerobics improve cardiovascular health and provide an all-body workout. Gentle and mild aerobics place minimal stress upon joints and can be especially beneficial as a form of physical activity for spinal cord injuries, according to the University of Washington Rehabilitation Medicine.Start by walking or using a manually operated wheelchair five minutes daily at a comfortable pace. Wear well-fitted, comfortable walking shoes if you are on foot. If standing upright, maintain good posture throughout your walk to stabilize your spine and minimize stress. As your strength builds, increase your time and pace.

Water activities can fit into a rehabilitation program for individuals unable to exercise on land. Water offers a natural buoyancy that supports the majority of your body weight, taking pressure and stress off of joints and making movement more effortless, enabling and pain-free, according to Texas Woman's University. If you are able, walk in water. The deeper the water, the more intense the workout you will get. Begin by holding onto the pool's side with your right hand or hold onto your instructor's hand. Walk around the pool's perimeter, using a comfortable pace. Swing your arms as you would on land and make certain your feet touch the pool's bottom. If walking the entire pool perimeter is too difficult, walk to the opposite side or across the pool's width. Another option involves walking in circles, starting with small circles and increasing to larger ones as your strength builds. If you are new to water walking, an instructors can help you develop proper form and prevent further injury.

What is a spinal cord injury?

A spinal cord injury can happen to anyone at any time. It’s a permanent and irreversible injury and prevention is the only cure.
On average, one person sustains a spinal cord injury every four days in Queensland – about 90 people each year.
Sustaining a spinal cord injury is a traumatic and devastating experience for any individual, and their family and friends. It changes their lives forever.
This short video explains the levels of function of spinal cord injury:
When the vertebrae of the spine are displaced or injured, the spinal cord, which is housed inside the spine, may also be injured. Spinal cord injury occurs if pressure is applied to the spinal cord, and/or the blood and oxygen supply to the cord is cut off.
The spinal cord can also become damaged as a result of the late effects of polio  or inflammation that may result from viral infections, abnormal immune reactions, or insufficient blood flow through the blood vessels located in the spinal cord (this can result in transverse myelitis – a neurological disorder caused by inflammation across both sides of one level, or segment, of the spinal cord).

If the spinal cord is damaged through crushing, bruising or severing the messages to and from the brain cannot get through. The millions of nerve fibres which make up the spinal cord cannot regenerate after injury.(Spinal Cord Injury Symptoms)
The damage to the spinal cord may be complete or incomplete, depending on the degree of injury to the nerve fibres. Incomplete injury can result in movement and sensation abnormalities and a complete injury usually means total loss of movement and sensation – permanent paralysis.
Generally, the level and degree of injury to the spinal cord will determine the extent and areas of paralysis. A person who has paraplegia will usually always have full use of their hands, arms and shoulders. The damage to their spinal cord will have occurred in the upper or lower back (thoracic, lumbar or sacral regions). A person who has quadriplegia will not be able to fully use their hands, arms and shoulders. The damage to their spinal cord will have occurred in the neck (cervical region).
Spinal damage can occur at the sacral or coccygeal levels. When this occurs, the bowel, bladder and the leg area below the knee are generally affected. However, many people who injure their spinal cord at this level will be able to walk with the assistance of special aids, such as a walking stick or foot splints etc.

Spinal cord injury research into nerve reconnection continues to be carried out throughout the world, including Australia.

What Are Complications Of C5 Spinal Cord Injury

Spinal Cord Injury can cause permanent disability or paralysis or loss of movement in several areas. It can also make a person lose sensation on the areas involved. The severity of spinal cord injuries depends on the level of the spinal cord affected, as well as the completeness of the injury. A spinal cord injury in the level of the 5th cervical spine, also known as C5, is relatively high. According to Brain & Spinal Cord.org, C5 spinal injuries can cause paralysis along with several complete or incomplete complications.

According to the spinal cord injury peer support group called Apparelyzed, people with C5 spinal cord injury will still be able to have full neck and head movement. However, they will have complete paralysis of the whole body, legs and arms, a condition known as quadriplegia. There is a complete loss of function in the fingers, hands and wrists. The shoulders and the biceps can also be potentially paralyzed. Sensation will also be lost in these areas, including a person's ability to feel touch, heat and cold.
Although the urinary bladder will still be able to do its job of storing urine, it will not be able to communicate to the brain because of the C5 spinal cord injury, hence the person will no longer have any control over bladder emptying, as stated by cpchildrentreatment.com . Furthermore, this increases the risk of developing urinary tract and kidney infections. As for the bowels, fecal incontinence, or the inability to control the anal muscles, will also be apparent. When it comes to sexual function, cpchildrentreatment.com reports that men may not be able to have a normal erection and ejaculation as they did in the past, while women may also experience changes in lubrication. Sensation and movement in these areas will be decreased or will be absent altogether.

Since patients with C5 spinal cord injuries experience paralysis in the extremities, the muscles in these areas may have changes in muscle tone. According to cpchildrentreatment.com , there are two types of problems when it comes to muscle tone. One is muscle spasticity, in which the patient experiences tightening or uncontrolled spasms in the affected muscles. On the other hand, the person may also have soft and limp muscles that lack muscle tone, a condition known as muscle flaccidity. Due to lack of movement, weight loss and wasting away of the muscles may occur.

What are Prognosis Of Spinal Cord Injury

A tethered spinal cord can present the patient with neurological impairments that can vary widely, from barely recognizable to profoundly disabling. Usually the symptoms first appear in childhood where there is adequate time to perform surgery. Early surgical intervention has the best prognosis for symptomatic relief since it can correct neurological damage before it progresses.
A tethered spinal cord is an abnormal condition that causes tethered spinal cord syndrome. The syndrome occurs as a result of tissue attachments between the spinal cord and the inside of the spinal column. The spinal cord normally floats in fluid, but these attachments limit movement by pulling on the spinal cord from the base of the spinal canal. As the patient grows, the spinal cord stretches and deforms as the bones around the spinal cord elongate. This can result in significant neurological dysfunction.

The spinal cord can become tethered for many reasons. The most common reason is a result of birth defects called myelomeningoceles, lipomyelomeningoceles or split cord malformation, Columbia University Medical Center notes. As the child grows, the spinal cord cannot stretch properly, which places stresses on the spinal nerves. The first symptoms are pain and younger children will fail to develop function in the legs. Older children may lose leg, bladder and bowel function. These symptoms usually are associated with unusual signs on the lower back including fatty deposits, hyperpigmentation, dimples or clumps of hair growth. These symptoms generally prompt a thorough physical examination, diagnosis and ultimately the recommendation for surgery. The surgery aims to release the spinal cord from the adhesions at the level of involvement. The prognosis for a child surgically treated for tethered spinal cord syndrome is good but declines with age, according to the Columbia University Department of Neurological Surgery.
Tethered spinal cord syndrome in adults is uncommon. However, if a child’s spinal cord tethering is allowed to progress untreated into young adult life, then the symptoms may have progressed where neurological damage, at least in part, is permanent. Surgery to remove the adhesions is usually successful, but the neurological symptoms may not resolve as completely as in younger patients, according to a January 2001 article by B. Iskander in the journal "Neurosurgical Focus." Pain alleviation varies from patient to patient. Urinary and bowel function may not resolve fully, but the outcome usually is favorable. The risks of surgery increase with the patient’s age.

The most common serious complication of tethered spinal cord surgery is an atonic bladder. This occurs when roots are damaged during surgery. Despite intraoperative monitoring, the risk of this complication is not improved. Another risk is leakage of cerebrospinal fluid which can cause neurological damage. Other risks are common to general surgery and include blood clots, deep vein thrombosis, infection, bleeding and other neurological damage.

Foods to Avoid for Spinal Cord Injury Patients

Foods to Avoid for Spinal Cord Injury Patients
spinal cord injury, a person's metabolism often changes significantly. Because they use fewer muscles, people with a spinal cord injury require fewer calories per day. However, if their eating habits do not change after their injury, they may be at risk for obesity and other related health conditions. Avoiding certain types of food after a spinal cord injury can help a person maintain a healthy weight.

Fast Foods
Fast foods are high on the list of foods to avoid after a spinal cord injury, or SCI, as they tend to pack excessive calories into a single meal. The Spinal Cord Injury Network reports that the average fast food meal contains around 1,200 calories. For some people, this may be half of their entire daily recommendation after their spinal cord injury. According to the National Guideline Clearinghouse, a person with a spinal cord injury usually requires around 10 percent fewer calories per day than the average person. They may need even less if they are severely impaired or inactive. Avoiding fast foods can help a person reduce his caloric intake, as well as avoid the excess fat, cholesterol and sodium that these foods tend to contain.
High-Sodium Foods
The Spinal Cord Injury Network recommends people with paraplegia or quadriplegia limit their sodium intake to between 500 and 1,000 mg daily. More than this amount may cause excess fluid retention, which can leave their bodies more vulnerable to related health conditions. Excess sodium can raise blood pressure, a risk factor for heart disease and stroke. Sodium is found not only in salt but also in many sauces, condiments and pre-made meals. Reading labels and avoiding high-sodium foods can help people living with SCI reduce their risk of heart attack and stroke.
Sugary Foods and Beverages
Foods that contain large amounts of sugar should also be avoided by those living with SCI. Sugary foods tend to be higher in calories, without the added benefit of extra nutrition. In other words, many high-sugar foods are empty calories. The Baylor College of Medicine recommends such foods make up only a minimal part of the daily diet for those living with SCI. These include sodas, candy, cookies and cakes. In addition, sweetened beverages, such as juices or tea mixes, may also contain excessive amounts of sugar.
Alcoholic Beverages
Alcohol is another empty calorie beverage, which not only adds to the daily calorie count without adding any nutrition but has other potential side effects as well. Alcohol can have an increased effect for someone with a spinal cord injury; because of this, daily consumption should be limited. Baylor recommends one drink per day for women with SCI and two for men with SCI as a maximum.
Other High-Fat Foods

In addition to fast foods and sweets, other junk foods, such as chips, should be limited by people with SCIs. However, even healthy foods can become high-fat foods if prepared a certain way. For example, fried chicken has substantially more calories and fat than baked or roasted chicken. In addition, limiting the amount of oil and butter used in food preparation can reduce calories while maintaining the same nutritional content. Finally, leaner cuts of meat can reduce saturated fat intake for those living with spinal cord injuries.

Rehabilitation for C5 Spinal Cord Injury

Spinal Cord Injury -- the part of the body that relays nerve signals from the brain -- is made of boney disks known as vertebrae that stack on top of each other to form a column. A sudden blow to the vertebrae -- for example, from a sports injury or a large fall -- can dislocate or fracture a part of the spinal cord. However, most injuries are less severe, usually resulting in pieces of vertebrae tearing into cord tissue or pressing down on the nerve tissue that sends signals. After the injury has been treated, a lengthy rehabilitation is needed to restore all possible functions.

C5 Spinal Nerve

The spinal cord injury includes several main parts. The topmost division, known as the cervical spine nerve, controls many of the muscles in the neck and arms. The C5 spinal nerve occurs on the fifth vertebra down and controls parts of the shoulders and biceps. However, every nerve below an injury site is affected, so a complete spinal cord injury will cause paralysis of the body and legs, in addition to the fingers and wrists. It is likely that you will retain full head and neck movement and good control of your shoulders, but if elbow movement is compromised, then you will be unable to bend or straighten the joint.

Rehabilitation will be mostly geared toward coping with and adapting to a change in lifestyle. Yet, depending upon the classification of the injury, muscle strength and mobility in many parts of the body may be regained to a certain degree. Those that are classified as an A injury are complete: nerve signals cannot be conveyed below the injured vertebra. The classification of B denotes that sensory but not motor function is preserved. Some physical therapy may help for injuries ranging from C, in which more than half of the key muscles are not strong enough to move the joint against gravity, to D, in which more than half of the key muscles allow the joint to move against gravity. A classification of E means that motor and sensory functions are normal, and physical therapy can restore much of the lost function.

Rehabilitation for Spinal Cord Injury


An injury to the C5 vertebra, which supplies nerves to the diaphragm, may cause a momentary stop to breathing, requiring immediate ventilation support. Once the vertebra is treated and breathing functions improve, most patients can be weaned from the machine in the weeks following the injury. However, patients may still have low stamina. The goal of rehabilitation from that point forward is to help the patient learn to use a device such as a walker, leg braces or a wheelchair to move and also use certain communication technologies. Occupational therapy will allow the patient to redevelop motor skills, if possible, and relearn basic functions such as toileting routines and self-grooming. If the injury is complete, then the patient will need help getting in and out of a wheelchair and with domestic care and personal assistance around the house.

Overview - Spinal Cord Injury

A spinal cord injury usually comes about as a result of a sudden or traumatic blow on the spine that either dislocates or fractures the vertebrae. The damage usually takes effect immediately when the disc material and bone fragments tear or bruise the tissues, but the spine is not severed at this time.
Most injuries are likely to cause compression and fractures to the vertebrae. This leads to the damage of axons, whose major role is to carry signals across the spine from the brain to other parts of the body. This can easily cause damage to a few or virtually all axons. One can completely recover from some of the injuries sustained, while in some cases it can lead to complete paralysis.
The damage to the nervous system can be minimized through emergency care and aggressive medical attention. This can even serve to restore some of the abilities of the affected person. One of the major manifestations of severe spinal complications is the inability to breathe. Majority of individuals with this condition are required to have respiratory support.
There are also some steroid drugs that held a great deal in reducing the damage to the nerve cells but this is if they are administered within eight hours of injury. The treatment process also incorporates rehabilitation programs that include skill building activities so as to give the patients the social and emotional support they need.
The injuries are classified as either complete or incomplete, where the latter means that the spine has the some ability to convey some messages from or to the brain. People suffering from injuries which are not severe are spared both the sensory and motor function beneath the affected area.
Complete injuries mean that there is no trace of motor or sensory below the affected area. Survivors of these injuries are likely to experience some medical complications such as bladder and bowel malfunction or chronic pain, to an extent of even developing some respiratory and cardiac problems. Having a quick recovery majorly depends on how well some of these chronic conditions are handled on a daily basis.
Both primary and secondary conditions might also occur even in the absence of spinal dislocation or fracture. Other causes might include the penetration of weapons or bullets in the spine, which might also be detrimental to the axons. The physical examination is done through testing the muscle strength, as well as checking whether the patient is sensitive to touch and whether the reflexes in the arms and legs are intact. X rays can also be used to identify the dislocation or the fracture of the vertebrae and other likely symptoms such as tumors and infections.

There have been some great advances in research in the area of spinal cord injury and doctors are optimistic that the treatment will be achievable in the future. The research is blended with other clinical research to establish some of the best physical rehabilitation techniques that will help in restoring the patient to normal functioning. The good news is that there have been some techniques that have significantly helped the patients to gain mobility within a short period of time.

Spinal Cord Injury Effects

Spinal Cord Injury may become severed or injured due to accidents, acts of violence or physical diseases such as polio, according to Dr. Edward Benzel of the Cleveland Clinic Spine Institute. Depending upon the extent and location of the spinal cord damage, a range of motor, sensory or autonomic nervous system functions (involuntary functions such as breathing) may be affected.
Spinal cord injury can cause partial or complete paralysis, or loss of motor function. Loss of movement may occur as a result of bruising, compression, lacerations or complete severing of the spinal cord. Partial paralysis (called paresis) can occur in all four limbs (quadraparesis), or slight paralysis may develop only in the lower extremities (paraparesis). In some cases, complete paralysis of the lower extremities and lower trunk may occur while the upper limbs remain unaffected (paraplegia). According to Dr. Edward Benzel, chairman of the Cleveland Clinic Spine Institute, loss of motor function typically occurs below the level of impact to the spinal cord, and paralysis may be temporary or permanent depending upon the severity of the injury. For example, if the cervical spine in the neck region is affected, loss of motor function is often seen in the hands, arms and neck. If the spinal cord in the lower back region is injured, loss of function may occur in the hips and legs.

Respiratory Problems

According to a review published in a 2007 issue of the Journal of Spinal Cord Medicine, spinal cord injuries--particularly those in the cervical or neck region--may lead to paralysis or paresis of the muscles that are responsible for involuntary respiration. Those who aren't able to breathe sufficiently on their own may require long-term mechanical ventilator support to survive; however, mechanical ventilation increases the risk of complications such as pneumonia, infection and death. The review's authors note that respiratory insufficiency is the top cause of morbidity and mortality after a spinal cord injury.

Autonomic Dysreflexia


Autonomic Dysreflexia, or hyperreflexia, is a life-threatening over-activity of the autonomic nervous system (responsible for controlling involuntary actions of muscles and organs in the body) that occurs uniquely in patients with spinal cord injury. According to the University of Washington Department of Rehabilitation Medicine, people with a severed spinal cord at or above the T-6 vertebrae are at greater risk of developing the condition. When pain or pressure (or a full bladder or bowel) below the level of spinal cord injury occur, blood vessels constrict and blood pressure rises. Nerves in the sympathetic nervous system relay a message to the brain that blood pressure is getting too high, and the brain in turn sends a signal down the spinal cord to relax blood vessels and lower blood pressure.

Nutrition & Diet for Spinal Cord Injury

Spinal cord injury can be a very serious condition that requires around-the-clock care for the patient. As a nurse, it's your job not only to make sure the patient is receiving any treatments, medications, or tests the doctor orders; it's also your job to see that the patient is comfortable, that he is taken care of mentally and emotionally as well. The complexity of a spinal cord injury requires you to pay close attention to every detail the patient tells you about or that you observe, so that you can report any problems or complications to the doctor in charge.

Q: What’s the connection between diet and spinal cord injury?

A: You’re susceptible to secondary health complications, like bladder infections, lower immune system, bowel dysfunction, respiratory infection, cardiovascular disease, osteoporosis. These can be prevented through a healthy lifestyle, which includes good nutrition. If you have these conditions already, it can help manage them.

Q: Does it pertain to spinal cord injury only?

A: The recommendations in the book are specific for spinal injury, but there is a great crossover to anybody with any kind of neurological condition, whether it be Multiple Sclerosis, Parkinson's, acquired brain injury.

Q: What’s the incentive?

A: If you can maintain your health and prevent a lot of these secondary complications from developing, it's saving yourself and the health-care system money down the road. We are also dealing with greater susceptibility toward weight gain, lower energy, sleep difficulty, so just trying to enhance your day-to-day function can make a significant difference.


The patient's environment needs to be suited to his needs at this point in time. Keep the room at a comfortable temperature, and make sure the patient has plenty of blankets. If the patient has urine or bowel incontinence, make sure that he stays clean and dry, as much as possible. You may need to administer pain medications, as needed, also as ordered by the physician. Also, make sure that the patient is getting enough rest by giving him as much privacy as he needs. If the patient can't rest, certain things can be done to aid him in this, such as visual imagery, where you help the patient to close his eyes and imagine a place he'd rather be at this time. For example, he might want to be on a beach, hearing and feeling the waves come lapping in, and the warmth of the sun beating down on him. Just being able to sit back and see all of this in his head and imagine this can help him to relax much more.

Foods to Avoid for Spinal Cord Injury Patients

After a spinal cord injury, a person's metabolism often changes significantly. Because they use fewer muscles, people with a spinal cord injury require fewer calories per day. However, if their eating habits do not change after their injury, they may be at risk for obesity and other related health conditions. Avoiding certain types of food after a spinal cord injury can help a person maintain a healthy weight.

Fast Foods

Fast foods are high on the list of foods to avoid after a spinal cord injury, or SCI, as they tend to pack excessive calories into a single meal. The Spinal Cord Injury Network reports that the average fast food meal contains around 1,200 calories. For some people, this may be half of their entire daily recommendation after their spinal cord injury. According to the National Guideline Clearinghouse, a person with a spinal cord injury usually requires around 10 percent fewer calories per day than the average person. They may need even less if they are severely impaired or inactive. Avoiding fast foods can help a person reduce his caloric intake, as well as avoid the excess fat, cholesterol and sodium that these foods tend to contain.

High-Sodium Foods

The Spinal Cord Injury Network recommends people with paraplegia or quadriplegia limit their sodium intake to between 500 and 1,000 mg daily. More than this amount may cause excess fluid retention, which can leave their bodies more vulnerable to related health conditions. Excess sodium can raise blood pressure, a risk factor for heart disease and stroke. Sodium is found not only in salt but also in many sauces, condiments and pre-made meals. Reading labels and avoiding high-sodium foods can help people living with SCI reduce their risk of heart attack and stroke.

Sugary Foods and Beverages

Foods that contain large amounts of sugar should also be avoided by those living with SCI. Sugary foods tend to be higher in calories, without the added benefit of extra nutrition. In other words, many high-sugar foods are empty calories. The Baylor College of Medicine recommends such foods make up only a minimal part of the daily diet for those living with SCI. These include sodas, candy, cookies and cakes. In addition, sweetened beverages, such as juices or tea mixes, may also contain excessive amounts of sugar.

Alcoholic Beverages

Alcohol is another empty calorie beverage, which not only adds to the daily calorie count without adding any nutrition but has other potential side effects as well. Alcohol can have an increased effect for someone with a spinal cord injury; because of this, daily consumption should be limited. Baylor recommends one drink per day for women with SCI and two for men with SCI as a maximum.

Other High-Fat Foods


In addition to fast foods and sweets, other junk foods, such as chips, should be limited by people with SCIs. However, even healthy foods can become high-fat foods if prepared a certain way. For example, fried chicken has substantially more calories and fat than baked or roasted chicken. In addition, limiting the amount of oil and butter used in food preparation can reduce calories while maintaining the same nutritional content. Finally, leaner cuts of meat can reduce saturated fat intake for those living with spinal cord injuries.

Symptoms of a C2 Spinal Injury

The spinal cord is divided into four segments: cervical, thoracic, lumbar and sacral. Together, they make up a vital part of the body's central processing nervous system; injury to the spinal cord can be grave and sometimes fatal. The cervical part of the spinal cord lies in the neck. Injuries occurring at the second cervical vertebrae, known as C2, manifest through a particular constellation of symptoms and signs.

As stated by the University of Alabama at Birmingham Spinal Cord Injury Information Network, an injury in the upper cervical region of the spinal cord—vertebrae C1 through C3—will cause complete paralysis of breathing muscles. This occurs because all the nerve signals sent by the brain originate at a higher level. An injury at C2 will interrupt the nervous system's signals to the muscles responsible for breathing. The muscles paralyzed by such an injury include the diaphragm, the chest and abdominal muscles, and the neck muscles. If the injury is complete and the spinal cord is completely transected at this level, the patient will lose the ability to breathe spontaneously and will need a ventilator.

The Merck Manuals Online Medical Library notes that injury of the spinal cord at C2 will result in complete or partial paralysis of all four limbs and trunk muscles. The muscles comprising the anal and bladder sphincters are also paralyzed causing the patient to lose voluntary control over urination and defecation. If the spinal cord is severely injured, the patient could remain paralyzed for life. If the injury is partial, however, the patient may regain some movement, particularly of the trunk muscles.

The nerves responsible for delivering sensation also pass through the spinal cord. Each spinal cord segment gives sensory supply to an area of the skin called a dermatome. All sensations are relayed to the brain via the spinal cord in order to provide feeling.


According to the American Spinal Injury Association, C2 provides sensory supply to the area over the back of the head and the top part of the neck. Injury at the C2 level will cause the patient to be totally deprived of sensations below that level because of the interruption of the pain pathway and the nerve signals going to the brain.

Vitamin C for Spinal Cord Injury

People with spinal cord injuries, or SCIs, may be advised to take vitamin C supplements or to eat foods that are high in vitamin C. This can help them avoid some SCI-associated complications, such as urinary tract infections or pressure ulcers. The recommended daily dose of vitamin C can vary based on a person's need and whether the vitamin is being taken for prevention or treatment.
Vitamin C and Healing
Vitamin C has long been used to prevent sickness. Vitamin C is an antioxidant and plays an important role in both healing and preventing potential infections. According to Medline Plus, vitamin C is a vital part of the connective tissue healing process, because it plays a major role in collagen formation. In addition, vitamin C can help prevent and fight bodily infections. Because it does not occur naturally in the body, vitamin C must be taken as a supplement or come from the foods you eat.
Vitamin C and Spinal Cord Injury
Medline Plus says that the average male needs around 90mg daily of vitamin C. However, a person who has a spinal cord injury may require more. People with spinal cord injuries are more prone to infections as well as pressure sores. Because of this, they may need additional vitamin C in their diet, both for healing and prevention. Pressure sores range from minor redness to total skin and underlying tissue breakdown. According to the National Guideline Clearinghouse, there is strong evidence that high doses of vitamin C improve pressure sore healing for people who have spinal cord injuries. Vitamin C is also effective at preventing and treating urinary tract infections, or UTIs, a common problem for those living with SCI.
How Much Vitamin C is Enough?
The recommended daily dose of vitamin C for people with SCI ranges from a few hundred to a few thousand milligrams daily, depending on the exact condition. For mild pressure sores, the National Guideline Clearinghouse recommends 100 to 200mg daily to enhance healing. However, for people with severe pressure sores, the recommendation increases to between 1,000 and 2,000mg. Northwest Regional Spinal Cord Injury System recommends that those who wish to avoid or treat a UTI take between 500 and 2,000mg of vitamin C every day.
Is Overdosing Possible?

Vitamin C is a hard vitamin to overdose on. It is water-soluble, meaning that it does not build up in the body over time. Medline Plus says that for most people, 2,000mg of vitamin C daily is safe. However, those who exceed the 2,000mg mark may be prone to vitamin C toxicity. If supplementing with vitamin C to avoid spinal cord injury complications, check with your doctor or a nutritionist to ensure you are getting the correct amount.

Paraplegia in Spinal Cord Injury

Spinal cord injuries are becoming more and more common. In fact, the Christopher and Dana Reeve Foundation estimates that there are more than one million people living with some type of spinal cord injury in 2010. A spinal cord injury that causes a loss of function in the legs is called paraplegia.

What Causes Paraplegia

Most spinal cord injuries are either the result of a motor vehicle accident or a work-related injury; however, other common causes include sports accidents, falls and violent crimes. The physical trauma of such accidents can compress or even sever the spinal cord, causing temporary or permanent damage. When the spinal cord damage affects the function of the lower limbs, it is termed paraplegia.

Effects of Paraplegia

In people with paraplegia, movement and sensation below the level of spinal cord injury is impaired to some degree. According to the Mayo Clinic, someone who is paraplegic will not only have symptoms in both of his legs, but also in his trunk and some of the organs in the pelvis. For some people, paraplegia disrupts bowel and bladder function. It may also impair sexual function. According to the National Spinal Cord Injury Association (NSCIA), paraplegia can affect the breathing muscles, and the ability to regulate temperature and blood pressure, depending on what part of the spinal cord is damaged.

Types of Paraplegia

Not all people with paraplegia end up in a wheelchair. This is because spinal cord damage can be either complete or incomplete. In complete paraplegia, all function is absent below the level of spinal cord injury. With incomplete paraplegia, however, some function below the level of spinal cord injury remains intact. For example, a person who is an incomplete paraplegic may be able to walk again with physical therapy, or may have control of her bowel and bladder. Additionally, paraplegics can have very different abilities based on their level of injury. A person with a high injury in the middle or upper back, for instance, may have more trunk weakness than a person with a lower back injury.

The NSCIA reports that while there is no known cure for spinal cord injury, many people with paraplegia recover function gradually, and may continue to gain function for a year or more following their injury. Treatment following a spinal cord injury with paraplegia involves stabilizing the spine, often through surgery, as well as physical and occupational therapy.


The prognosis for someone with paraplegia is based on his level of injury, and whether or not his spinal cord is completely or incompletely damaged. However, the NSCIA stresses that most people with paraplegia from spinal cord injuries are able to have "normal" lives, just like anyone else. They may just learn to do things in a different way. These days, a person with paraplegia can hold a job, have a family and participate in almost any imaginable recreational activity using adaptive devices and specialized equipment.

Types of Spinal Cord Injury

Spinal cord injuries are classified according to the site, or level of injury, and as complete or incomplete. Complete, means there is absence of all motor, sensory and vasomotor function below the level injury. Incomplete, means there is presence of some voluntary motor or sensory function below the level of the injury.

Central Cord Syndrome

With central cord syndrome, also an incomplete cord injury, there is damage to the center of the spinal cord. Motor and sensory deficits are less severe in the lower extremities than in the upper extremities. The person with this type injury may not be able to move his arms, but may be able to move his legs.

Posterior Cord Syndrome

Posterior cord syndrome involves injury to the back portion of the spinal cord. Persons with posterior cord syndrome have a loss of proprioception, the body's own ability to perceive its positioning of body parts, fine touch and fine pressure. Patients retain intact motor function, pain and temperature. They are also able to detect touch that has significant pressure. Posterior cord syndrome is an incomplete cord injury.

Complete Cord Injuries


With a complete spinal cord injury, the cord is literally cut in two. According to "Sheehy's Manual of Emergency Care," the hallmark of complete cord lesion is paraplegia or quadriplegia, also called tetraplegia. With these injuries, there is absence of all motor, sensory and reflex below the level of injury. It is common to hear people speak of those who are quadriplegic or paraplegic. A person who is a paraplegic has loss of muscle ability in both arms or both legs. A person who is a quadriplegic has loss of motor function in both arms and both legs.