Spinal cord injuries are classified as complete or incomplete depending on how much of the cord width is damaged. It is very difficult in the prehospital setting to identify whether an injury is complete or incomplete, and the role of the first aider is to minimise movement and protect the patient from further injury.
Complete injuries
Complete spinal cord injury is the term used to describe damage to the spinal cord that is absolute. It causes complete and permanent loss of ability to send sensory and motor nerve impulses and, therefore, complete and usually permanent loss of function below the level of the injury.
Incomplete injuries
Incomplete spinal cord injury is the term used to describe partial damage to the spinal cord. With an incomplete lesion, some motor and sensory function remains. People with an incomplete injury may have feeling, but little or no movement. Others may have movement and little or no feeling.
Level of a spinal cord injury
The level of the spinal cord injury refers to the vertebra that the injury is closest to. For example, an injury to the spinal cord at the level of the sixth cervical vertebra would be referred to as a C6 injury (C for cervical). When the spinal cord is injured, the brain’s ability to communicate with the body below the level of the injury may be reduced or lost. When that happens, the part of the body affected will not function normally.
The closer to the head the spinal cord injury is, the greater the area of the body that may be affected. For example, a person with a thoracic spinal injury may lose use of the legs (paraplegia) but the arms will not be affected. A person with a cervical injury may lose use of the legs and arms (referred to as tetraplegia or quadriplegia).