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A Helpful Guide to Cervical Spine Injury

Cervical spine injury is a serious, life-threatening emergency that can cause paralysis throughout your entire body.

This guide to cervical spine injury will help you understand what to expect with each different level of injury.

What is the Cervical Spine?

Your spine is made up of 33 bone segments called vertebrae starting from the top of your neck to your tailbone.

The cervical spine consists of the first 7 vertebrae that are numbered C1-C7, which make up your neck.

There are 8 cervical spine nerve pairs, one between each vertebra. The order goes: C1 nerve, C1 vertebra, C2 nerve, C2 vertebra, and so on.

Did you notice that there’s a C8 nerve but no C8 vertebra? That’s because the cervical region ends at the C8 nerve and leads into the thoracic region of the spine.

Cervical Spine Injury and Quadriplegia

cervical spinal cord injury and quadriplegia

The cervical spine might only make up your neck, but cervical spine injury will affect nearly your entire body.

The spinal cord is the passageway in which the brain and body connect. The peripheral nerves that branch off your spinal cord link to the rest of the body, but in cases of spinal cord injury, brain signals can’t get past the site of injury.

This leads to partial or complete paralysis to all the muscles connected to the area below the injury.

The higher up the spine your injury is, the more parts of your body it will affect. This is what makes cervical spine injury is the most debilitating type of spinal cord injury.

All cervical spine injuries will lead to quadriplegia. 

Quadriplegia (aka tetraplegia) is when both the upper and lower body experiences some form of paralysis. Almost 60%  of all spinal cord injuries result in quadriplegia.

All individuals with quadriplegia will have paralysis in their entire lower body; however, they will experience varying levels of upper body control depending on the location of their cervical spine injury.

Cervical Spine Injury Causes

neck injury after car accident

Cervical spine injury is typically caused by violent impact accidents like:

  • diving into shallow waters
  • sports
  • falling
  • violence
  • motor vehicle collisions

The cervical region is less stable than the lower regions of the spine because it bears less weight and has a greater range of motion.

Rear-end collisions can cause forceful jerking of the neck, which often injures the bones, muscles, and tissues that make it up.

Cervical Spine Injury Levels

Spinal cord injury recovery starts from the top down, so it’s important to be aware of what functions you might regain with each level of injury.

Below, you can find information on your specific type of cervical spine injury.

Dermatomes for cervical spine injury
Photo Credit: Ralf Stephan

C1 Spinal Cord Injury

The C1 vertebra is also called the atlas. It connects the skull to the spine and helps support the head, allowing it to make up-and-down nodding motions.

C1 spinal cord injury is the most severe and is often fatal; luckily, is rare and only occurs in 1-2% of all spinal injuries.

It can lead to loss of involuntary functions like breathing and will require the aid of a ventilator.

You’ll need full assistance of a caregiver to carry out daily tasks due to extremely limited (if any) ability to move.

Ability to talk can also become impaired which will make communication difficult.

C2 Spinal Cord Injury

The C2 vertebra is also known as the axis and it allows you to rotate your head side-to-side as if signaling ‘no’.

Along with the atlas, the axis helps support the head and provide the neck with a greater range of motion than the rest of the spine.

Like a C1 injury, C2 spinal cord injury will require a ventilator to help you breathe, full assistance of a caregiver to carry out everyday tasks and may result in limited speaking ability.

C3 Spinal Cord Injury

Like a C1 and C2 injury, a C3 spinal cord injury will require a ventilator to control breathing.

C3 spinal cord injury patients generally can speak and move their heads and neck.

C4 Spinal Cord Injury

A C4 spinal cord may require the aid of a ventilator for breathing because the C4 nerves connect directly to the diaphragm.

C4 spinal cord injury patients should be able to move their head, neck, and some parts of the shoulders.

C5 Spinal Cord Injury

Those with a C5 spinal cord injury will be able to normally move their head, neck, and shoulders.

C5 spinal cord injury patients can speak regularly but may still experience weak breathing.

Some upper extremity control is also possible, such as the ability to bend elbows.

C5 nerve connects to the deltoids (which are responsible for shoulder movement), biceps and brachioradialis (which are responsible for elbow flexion and forearm rotation).

C6 Spinal Cord Injury

Along with regular breathing, head, neck, shoulder, and elbow functions, C6 spinal cord injury patients generally have at least some control over their wrists.

Although they won’t have hand function, C6 patients can start to get a feel for independence.

With the help of specialized tools like grip attachments, C6 spinal cord injury patients should be able to carry out everyday tasks like eating, grooming, and getting dressed on their own.

C7 Spinal Cord Injury

C7 spinal cord injury patients generally can control their upper extremities, but experience only partial hand function.

They can fully extend their arms, rotate and lift their shoulders, and start to move their fingers.

C8 Spinal Cord Injury

C8 spinal cord injury patients should have completely normal arm function with weakness in their hands and fingers.

They are usually able to independently carry out daily living activities and should be able to grip and pick up objects.

C8 patients should practice hand exercises to help recover strength and dexterity in their fingers and wrists.

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