The Levels Of Paralysis

In his book Still Me, Christopher Reeve describes the world of paralysis candidly. The loss of all privacy. The most intimate body functions. He says the first question he asks when he hears someone has become paralyzed is "What level?" This tells him and can tell everyone how far down the newly paralyzed person will retain movement and thus independence.

There is a public perception that paralysis means limbs just lie quietly. dead. They don't. As Reeve describes it, they flop around as if they have a mind of their own and when a man is over 200 pounds, they can unwittingly injure people.

Always the ventilator breathes for him, one machine between him and suffocation. He has worked for years to learn how to talk with it and to breath without it, and has accomplished minutes without it, but always it reclaims him.

Paralysis will generally "descend" which means some movement will return two levels below the injured vertebrae. In Reeve's case, he would regain movement in the shoulders and the ability to breathe for brief periods on his own and the ability to talk.

What does the level mean for other people?

The Spine

The spine has 29 vertebrae, divided into four sections. Starting at the top, the sections are cervical (neck), thoracic (chest), lumbar (back) and sacral (tail).

These are divided as follows: cervical 7, thoracic 12, lumbar 5, sacral 5.

The vertebrae do not quite exit in the order in which one might think. The Spinal Cord Institute SCI offers complete charts illustrating how the vertebrae stack up in the spine and what nerves they protect.

While the cervical vertebrae protect the nerves of the head and arms, the first thoracic vertebrae protects the nerve of the little finger. Otherwise the thoracic vertebrae control the chest nerves, the lumbar control the leg muscles, and the sacral vertebrae covers the heel and the middle back of the leg, back of the thighs, part of the buttocks and perineal region.

Loss of Bodily Function

The anal nerve is vital in determining if a fracture is complete or incomplete. If there is no sensation there, the fracture is termed complete and the chances of recovery are lowered dramatically.

The loss of bodily function also determines the level of the spine that is damaged. If the biceps don't work, the injury is determined to be C4. It's a very complicated process and explained well at the Spinal Cord Injury site. Their chart Paralysis Level Chart helps us understand how the nerves and vertebrae work.

Remember, the level of paralysis felt by a newly injured person does not mean that will be the final level felt. Keep hope alive. Don't give up. Not on life and not on yourself.