High-Cervical Nerves (C1 – C4)
Most severe of the spinal cord injury levels
Paralysis in arms, hands, trunk and legs
Patient may not be able to breathe on his or her own, cough, or control bowel or bladder movements.
Ability to speak is sometimes impaired or reduced.
When all four limbs are affected, this is called tetraplegia or quadriplegia.
Requires complete assistance with activities of daily living, such as eating, dressing, bathing, and getting in or out of bed
May be able to use powered wheelchairs with special controls to move around on their own
Will not be able to drive a car on their own
Requires 24-hour-a-day personal care
Low-Cervical Nerves (C5 – C8)
Corresponding nerves control arms and hands.
A person with this level of injury may be able to breathe on their own and speak normally.
C5 injury
Person can raise his or her arms and bend elbows.
Likely to have some or total paralysis of wrists, hands, trunk and legs
Can speak and use diaphragm, but breathing will be weakened
Will need assistance with most activities of daily living, but once in a power wheelchair, can move from one place to another independently
C6 injury
Nerves affect wrist extension.
Paralysis in hands, trunk and legs, typically
Should be able to bend wrists back
Can speak and use diaphragm, but breathing will be weakened
Can move in and out of wheelchair and bed with assistive equipment
May also be able to drive an adapted vehicle
Little or no voluntary control of bowel or bladder, but may be able to manage on their own with special equipment
C7 injury
Nerves control elbow extension and some finger extension.
Most can straighten their arm and have normal movement of their shoulders.
Can do most activities of daily living by themselves, but may need assistance with more difficult tasks
May also be able to drive an adapted vehicle
Little or no voluntary control of bowel or bladder, but may be able to manage on their own with special equipment
C8 injury
Nerves control some hand movement.
Should be able to grasp and release objects
Can do most activities of daily living by themselves, but may need assistance with more difficult tasks
May also be able to drive an adapted vehicle
Little or no voluntary control of bowel or bladder, but may be able to manage on their own with special equipment
