Spinal Cord Injury

What is a Spinal Cord Injury?

The spinal cord is the main pathway through which the brain communicates with the rest of the body. When it is damaged, those signals are interrupted. A spinal cord injury (SCI) can cause partial or complete loss of movement (motor function) and sensation below the site of the injury.

SCIs are classified by the level of the spine where the injury occurs and whether the injury is complete or incomplete. A complete SCI means there is no motor or sensory function below the injury level. An incomplete SCI means some function remains. The American Spinal Injury Association (ASIA) classification system (grades A–E) is widely used to describe injury severity.

Injury levels and functional outcomes:

• Cervical (C1–C8) — affects arms, trunk, and legs; high cervical injuries may affect breathing
• Thoracic (T1–T12) — affects trunk and legs; arm and hand function usually intact
• Lumbar (L1–L5) — affects hips and legs
• Sacral (S1–S5) — affects hips, thighs, and bladder/bowel function

Terms used include tetraplegia (formerly "quadriplegia") affecting all four limbs and paraplegia affecting the lower body.

How It Presents

In addition to loss of movement and sensation, SCIs commonly affect:

• Bladder and bowel function — requiring management strategies such as catheterization
• Respiratory function — particularly with high cervical injuries
• Blood pressure regulation — autonomic dysreflexia is a potentially dangerous response to stimuli below the injury level
• Pain — neuropathic (nerve) pain is common, including burning or stabbing sensations
• Sexual function and fertility
• Skin integrity — pressure injuries are a significant risk due to reduced sensation

Psychological adjustment is a major part of life after SCI. Many people go on to live full, active lives, though this often requires substantial adaptation, equipment, and support.

Assistive Technology

AT is central to independence after SCI:

• Power wheelchairs — especially for those with tetraplegia; can be controlled by breath (sip-and-puff), head arrays, or eye gaze
• Manual wheelchairs — commonly used by people with paraplegia who have strong upper-body function
• Adapted vehicles — hand controls, spinner knobs, and accessible vans enable driving independence
• Voice control and smart-home tech — reduces reliance on physical interaction for home environments
• Exoskeletons — powered wearable frames that can enable standing and walking for some users
• Environmental control systems — controlling lights, doors, and appliances without hand use
• Pressure-relief cushions and mattresses — prevent pressure injuries

Common Misconceptions

• "People who use wheelchairs cannot feel anything." Incomplete SCIs leave varying degrees of sensation. Even complete SCIs vary; some people retain partial sensation.
• "SCI means you'll never work or be in a relationship." Many people with SCI have active careers, relationships, and families.
• "Recovery is impossible after the first year." While most recovery occurs in the early period, neuroplasticity research and emerging therapies continue to show potential beyond traditional timelines.

Language and Identity

Person-first language ("person with a spinal cord injury") is generally preferred in clinical and advocacy contexts, though individual preferences vary. The SCI community is diverse, and many members identify strongly with the broader disability rights movement and its social-model framing — understanding barriers as societal constructs, not inevitable consequences of injury.