A C1 spinal cord injury is the most severe and fatal type of spinal cord injury.
Fortunately, it’s not very common and only occurs in 1-2% of all spinal cord injuries.
This article will go over everything you need to know about C1 SCIs. But first, let’s go over the anatomy of your spinal column for some background.
Anatomy of the Spinal Column
The spinal cord is protected by the spine, and the spine is made up of bone segments called vertebrae. Each spinal nerve exits above its corresponding vertebra.
The cervical region of the spine is composed of 7 vertebrae, so the order is C1 nerve, C1 vertebra, C2 nerve, C2 vertebra, and so on.
The C1 and C2 vertebrae are different from other vertebrae in terms of shape and function. Despite being the smallest vertebrae in the cervical region, they allow for the most mobility.
The C1 vertebra (the atlas) is the uppermost vertebra. It connects to the base of the skull and forms the atlanto-occipital joint. This is what allows you to nod your head up and down.
The atlas is shaped like a ring and connects to the C2 vertebra (the axis) and forms the atlanto-axial joint, which is what allows you to shake your head from left to right.
Because the C1 and C2 vertebrae are so closely aligned, C1 and C2 injuries typically occur together.
The atlas and axis are crucial because they stabilize the skull, enable neck movement, and protect the spinal cord.
Determining Level of Injury
When determining level of injury, physicians will test your sensory and motor functions in accordance with the International Standards Examination.
The C1 nerve root does not have a sensory component to test for; however, if sensation is abnormal at C2, the sensory level is classified as C1.
Causes & Demographics of C1 Spinal Cord Injury
The most common causes of C1 spinal cord injuries are:
- Diving into shallow waters
- Motor vehicle accidents
The majority of C1 spinal cord injuries in younger patients occur in males.
However, in elderly patients, the occurrence is split relatively evenly between males and females.
The age demographics that are most at-risk for C1 fractures are individuals in their mid-twenties and the elderly between the ages of 80-84.
What to Expect After a C1 Spinal Cord Injury
Without immediate medical attention, C1 spinal cord injuries are typically fatal.
The higher the injury, the greater the loss of function.
Because it is the first nerve of the spinal cord, injury to the C1 nerve will result in impaired motor and sensory function throughout your entire body
So now that you have a little background on the anatomy and causes of C1 spinal cord injuries, let’s go over what you can expect after injury.
1. Ventilator Assistance
Injury to the upper spinal cord is extremely serious because it affects the respiratory muscles and may result in an inability to breathe.
Therefore, someone with a C1 spinal cord injury will need the help of a ventilator to breathe.
2. Full-Time Care
A C1 spinal cord injury will result in quadriplegia (aka tetraplegia), which is paralysis of both the upper and lower body.
Depending on the severity of injury, a C1 SCI patient will likely need the full-time assistance of a caregiver to perform activities of daily living like bathing, grooming, feeding, and toileting.
3. Muscle Atrophy
With such restricted movement, muscle atrophy is inevitable.
Muscle atrophy is when your muscles shrink due to disuse.
This can also result in poor circulation and a greater risk of injury.
4. Bladder, Bowel, & Sexual Dysfunction
Patients will have to rely on catheters and other bladder & bowel management techniques.
5. Limited Communication
C1 spinal cord injury can also affect your ability to speak, and in combination with restricted body movements, it can be extremely difficult to communicate.
There won’t be anything wrong with your brain, so your thoughts will be coherent. However, because of your motor impairments, expressing your thoughts may be problematic.
Life Expectancy of C1 Spinal Cord Injuries
As previously mentioned, C1 spinal cord injuries are very serious and need immediate medical attention. Mortality rates are significantly higher for C1 SCIs than other levels of injury.
The more motor and sensory impairments you experience after a C1 SCI, the lower your life expectancy.
C1 Spinal Cord Injury Treatment
There currently is no cure for spinal cord injury; however, there are ways to manage and stabilize the spinal cord after injury.
Mild fractures to the C1 vertebrae are generally managed with some sort of cervical collar or halo brace to keep the spine aligned.
More severe cases will require surgery to prevent vertebrae from further compressing the spinal cord.
Methylprednisolone is a steroid that is often used to help reduce swelling in the spinal cord.
C1 Spinal Cord Injury
That’s a wrap! Injury to your C1 spinal nerves will result in the greatest amount of motor and sensory impairments.
This region of the spinal column is essential for supporting the skull, protecting the spinal cord, and enabling neck movements.
If you or a loved one has experienced a C1 SCI, we hope that this article helped you better understand what it entails.
C1 spinal cord injuries can be mild or severe, so functional impairments can vary. Every spinal cord injury is different and there’s always hope for recovery. Good luck!