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Thoracic Spine Injury: What to Expect and How to Cope

xray of thoracic spine injury

Wondering what to expect after a thoracic spine injury?

Thoracic spine injury occurs when you injure one of the 12 vertebrae that make up the area between your upper and mid-lower back. The vertebrae are labeled T1-T12. 

Following each vertebra is its corresponding spinal cord segment. When vertebrae compress the spinal cord, individuals can experience paralysis and loss of sensation in their trunk and lower body (paraplegia). 

Depending on the severity of the injury, the amount of control and sensations spared will vary. Some people may be partially paralyzed and have difficulty coordinating their leg movements while others may be completely paralyzed and unable to move their legs. However, even those who appear to be completely paralyzed may show some signs of recovery. 

This article will educate you on what functions are affected at each level of injury, how to recover, and provide suggestions for coping.

Functions Affected by Thoracic Spine Injury

The thoracic spinal cord innervates the muscles and skin that make up the inner regions of your arms as well as your chest and trunk.

The higher the level of your spinal cord injury, the more functions will be affected. This occurs because brain signals are not able to get past the injury site. Level of injury refers to the lowest region of the spinal cord where normal feeling and motor control exists.

For example, a T1 spinal cord injury will affect control and sensation innervated at the T2 level of injury below . However, depending on the severity of injury, some functions may still be able to receive messages from the brain.

As you can see in the diagram below, the areas of skin innervated by the thoracic region are very closely aligned and will result in similar effects. Therefore, we’ll describe the thoracic levels of injury in 2 general sections:

diagram of functions affected by thoracic spine injury

Photo Credit: Ralf Stephan

T1, T2, T3, T4, T5 Spinal Cord Injury

T1-T5 thoracic spine injuries primarily affect the muscles in the upper chest, mid-back, and a section of the inner arms.

The T1 nerve roots affect sensation in your inner forearm and the ability to spread your fingers apart from each other.

T2 nerve roots affect sensation around the armpits and upper chest.

T3, T4, and T5 nerve roots affect sensation at the upper chest and back.

Additionally, higher-level thoracic injury patients may experience difficulties sitting upright due to lack of core control. In such cases, individuals may need to wear a back brace or chest strap to support their trunks.

T6, T7, T8, T9, T10, T11, T12 Spinal Cord Injury

T6-T12 spinal cord injuries affect the chest, trunk, and abdominal muscles.

Patients with lower thoracic spinal cord injuries generally have partial trunk control and are able to sit upright independently.

Additionally, T6-T12 SCI patients generally are able to perform transfers in and out of wheelchairs independently.

Life After Thoracic Spine Injury

Despite having lower body paralysis, many thoracic spinal cord injury patients live normal lives and active lives.

They learn to adapt and may have to do some things differently.

In the following sections, we’ll go over management interventions that can help you recover after a thoracic spine injury.

Rehabilitation Therapy

man with thoracic spinal cord injury at physical therapy

©iStock.com/kzenon

Rehabilitation therapies can help you recover physically and mentally.

The most common rehabilitation therapies for spinal cord injury patients are physical therapy, occupational therapy, and psychotherapy.

Physical and occupational therapy both focus on improving functional mobility, but through different approaches.

Physical therapy uses targeted exercises while occupational therapy teaches adaptive techniques for activities of daily living like getting dressed and performing transfers related to self care.   

Psychotherapy can help patients manage the psychological effects of thoracic spine injury.

Adaptive Tools

Adaptive tools can be extremely helpful for promoting independence after thoracic spinal cord injury.

For example, setting up ramps or support bars throughout the house can make it much easier to be independent, especially in a wheelchair.

If you have a weak core, a reacher can help you pick items up without straining or falling over.

Spinal Cord Injury Support Groups

Joining a spinal cord injury support group is a great way to cope after spinal cord injury.

There, you’ll be surrounded by other people who understand what you’re going through. You’ll also learn how other in the same situation are living full, productive lives.

You can share experiences and learn about excellent resources to help you during challenging times.

Recreation

man with thoracic spinal cord injury playing basketball

©iStock.com/nautiluz56

After a thoracic spinal cord injury, you may feel discouraged from participating in your favorite activities. However, you’ll soon discover that as long as you have an open mind and are willing to adjust, you can still be involved in many activities, or develop new interests!

Tons of sports are now adapted for individuals with paraplegia including basketball, rugby, and bowling.

Pool therapy is very effective to practice standing or walking. The buoyancy will eliminate the pressure of you weight so that you can focus on specific movements with ease.

This is also a great opportunity to explore new hobbies. Not into sports? Consider cooking, pottery, painting, or photography!

Can You Fully Recover from a Thoracic Spine Injury?

Recovery from a thoracic spinal cord injury depends on many different factors.

Some factors (like the level and severity of your injury) are uncontrollable, but there are many things you can control including:

  • Training intensity
  • Diet
  • Mindset

Spinal cord injury recovery is about promoting neuroplasticity through massed practice. Neuroplasticity is the spinal cord’s ability to rewire itself so that functions affected by damage to the spinal cord can be relearned.

Damage to the spinal cord cannot heal itself. However, undamaged areas can rewire and make adaptive neurological changes.

The best way to promote neuroplasticity is to continuously repeat weakened movements. This is why training intensity plays such a significant role in recovery outlook. The more repetitions you perform, the more you’re stimulating your spinal cord’s ability to rewire itself.

It’s also important to keep in mind that neuroplasticity is limited. Therefore, the more spared neural pathways you have at your level of injury, the better your recovery outlook.

Regardless, as long as you have some spared neural pathways at your level of injury, functional improvement is possible.

Understanding Thoracic Spinal Cord Injury: Key Points

Thoracic spinal cord injuries directly affect movement and sensation in your inner arms and trunk.

However, they will also affect your lower limb functions because messages from the brain will not be able to get past the injury site.

Thoracic spinal cord injury patients generally have normal upper extremity functions, but those with T1 injuries may experience lack of sensation around the armpit.

Generally, thoracic spine injury patients are capable of living very independent and fulfilling lives through rehabilitation therapy, a positive mindset, and a willingness to adapt.

Hopefully, this article helped you better understand what to expect after a thoracic spinal cord injury. Good luck!

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