Wondering what to expect after a thoracic spinal cord injury?
Following a thoracic spinal cord injury, individuals experience loss of motor control and sensation in the trunk and/or legs (paraplegia).
Depending on the level and severity of the spinal cord injury, the amount of motor control and sensation spared will vary. Some individuals experience weakness and have difficulty coordinating their leg movements while others may be completely paralyzed.
This article will discuss what functions are affected at each level of thoracic spinal cord injury and how to promote recovery.
Functions Affected by Thoracic Spinal Cord Injury
Nerves from each level of the spinal cord is connected to a different set of muscles for movement and area of skin for sensation. The thoracic region of the spinal cord innervates the muscles and areas of skin that make up the trunk and inner arms.
It consists of 12 levels: T1-T12. The higher the level of your spinal cord injury, the more functions will be affected. This occurs because signals from the brain are not able to pass through the damage, disrupting the transmission of messages to areas below the level of injury.
As a result, individuals with thoracic spinal cord injuries also experience paralysis in their lower bodies. However, depending on the severity of the injury, some signals from the brain may be able to reach areas below the level of injury through spared neural pathways.
As you can see in the diagram above, the areas of skin innervated by the thoracic region are very closely aligned with the location of innervated muscles. Following a thoracic spinal cord injury, individuals may experience a partial or complete lack of sensation below the level of injury. In the following sections, we’ll describe the thoracic levels of injury in 2 general sections: T1-T5 SCIs and T6-T12 SCIs.
T1, T2, T3, T4, and T5 Spinal Cord Injuries
T1-T5 thoracic spinal cord injuries primarily affect the muscles in the upper chest, mid-back, and inner arms. As a result, individuals with higher-level thoracic injuries may experience difficulties sitting upright due to a lack of trunk stability.
The T1 nerve roots affect sensation in your inner forearm and the ability to spread your fingers apart.
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, individuals with T6 or higher level injuries are more likely to experience a condition called autonomic dysreflexia which affects involuntary functions like body temperature regulation, heart rate, and blood pressure. Without proper management, autonomic dysreflexia can be life-threatening. Therefore, it is essential for at-risk individuals to be aware of potential triggers and avoid them.
T6, T7, T8, T9, T10, T11, and T12 Spinal Cord Injures
T6-T12 spinal cord injuries affect sensation and motor control around the trunk and abdominal muscles. As a result, motor control and sensation in their arms and chest should not be affected.
The T6 nerve roots generally affect sensation around the top of the abdomen. Each consecutive set of nerve roots innervates a lower portion of the trunk.
Individuals with lower-level thoracic spinal cord injuries generally have enough trunk control that they can sit upright and perform transfers independently.
It’s important to remember that while the level of the SCI provides general information regarding functional outcomes, the severity of the spinal cord injury greatly affects the functional abilities retained following the injury. The affected motor control and sensation of someone with any specific level of SCI can vary significantly, resulting in differing functional abilities.
If a spinal cord injury is complete, the brain is unable to send any information past the level of injury, resulting in a complete loss of motor control and sensation below the injury level. However, those with incomplete spinal cord injuries have some spared neural pathways, meaning that some information from the brain can still be transmitted past the level of injury. Therefore, they will retain some motor control and/or sensation below the injury level.
Now that you understand how sensation and motor control are affected after a thoracic spinal cord injury, the following section will discuss effective management interventions.
Thoracic Spinal Cord Injury Management
Despite having lower body weakness or paralysis, many individuals with thoracic spinal cord injuries live functional, active lives by learning to adapt.
In the following sections, we’ll go over management interventions that can help you recover after a thoracic SCI.
Rehabilitation therapies play an essential role in the spinal cord injury recovery process. The most common rehabilitation therapies for spinal cord injury patients are physical therapy, occupational therapy, and psychotherapy.
Physical therapy uses targeted exercises to improve motor control, maintain range of motion, and stimulate the spinal cord.
Occupational therapy teaches individuals how to be more functional by practicing activities of daily living like putting on clothes and performing transfers. This often involves learning adaptive techniques to compensate for weakness or paralysis of the trunk and/or lower body.
Psychotherapy may help individuals learn more effective ways to cope after a spinal cord injury.
An occupational therapist may recommend adaptive tools and home modifications to help promote 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.
Additionally, those with affected trunk stability following a thoracic SCI may benefit from using a reacher to 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 others in similar situations are learning to cope, which can help you during challenging times.
Can You Fully Recover from a Thoracic Spinal Cord Injury?
Recovery from a thoracic spinal cord injury depends on many different factors.
While some factors (such as the level and severity of your SCI) cannot be controlled, there are ways to promote recovery. Factors that can be controlled include:
- Early participation in rehabilitation
- Training intensity
- Physical activity levels
- Management of secondary effects
Spinal cord injury recovery primarily focuses on promoting neuroplasticity through massed practice. Neuroplasticity is the spinal cord’s ability to rewire itself and make adaptive changes so that functions affected by damage can be relearned. However, only undamaged neural pathways are capable of utilizing neuroplasticity. Therefore, those with milder SCIs generally have a better recovery prognosis.
The best way to promote neuroplasticity is to consistently practice affected movements. Highly repetitive movements help stimulate the spinal cord and reinforce demand for those functions to promote neurological adaptations.
Understanding Thoracic Spinal Cord Injury: Key Points
Thoracic spinal cord injuries directly affect movement and sensation in your inner arms and trunk. However, they also affect lower limb functions because messages from the brain cannot always travel past the injury site.
Individuals with thoracic spinal cord injuries are often capable of living very independent, fulfilling lives by participating in rehabilitative therapies, maintaining a positive mindset, and making adaptive changes.
We hope this article helped you understand what to expect after a thoracic spinal cord injury. Good luck!
Image credits: Ralf Stephan and ©iStock.com/kzenon/nautiluz5