By Doriel Seno
Do you know that the incidence of spinal cord injury (SCI) in the US is around 54 per one million people per year? SCI cases disproportionately affect African Americans, who represent approximately 25% of the total number of people who have sustained SCIs.
Spinal Cord Injuries (SCIs) are distinguished based on the severity and location of the injury to the spinal cord. When one sustains these kinds of injuries, they eventually lose their mobility and sensation. The SCI patient may have decreased functionality in various parts of their body.
There are two types of spinal cord injuries: complete and incomplete. The category of SCI may depend on the level of the spinal injury, i.e., cervical, thoracic, lumbar, or sacral. This information is important in determining the extent of damage and the appropriate treatment that the victim should get.
Let’s discuss how spinal cord injury classifications affect case outcomes.
A complete injury results from a total loss of both motor and sensory functions in the sacral region, which represents the lowest part of the spinal cord. When one sustains such an injury, they will feel a complete loss of conscious perception and muscle movement below the level of the injury.
An incomplete injury means that some sensory or motor function remains intact beyond the designated neurological boundary, which includes the sacral regions. The range of functional outcomes from incomplete injuries extends beyond that of complete injuries. Patients with incomplete injuries maintain some sensory capacity while experiencing limited functional abilities.
The National Spinal Cord Injury Statistical Center (NSCISC) database currently records incomplete spinal cord injuries as the most common type of spinal cord injury.
Neurological level of injury (NLI) is the lowest spinal cord segment at which sensory and motor function can be considered relatively normal bilaterally. Physicians use it to describe the severity and characteristics of a spinal cord injury, in conjunction with the American Spinal Injury Association Impairment Scale (AIS) grade.
Cervical-level injuries, which occur from C1 to C8, result in tetraplegia. Tetraplegia refers to a condition wherein there is a total loss of function in all four limbs. The most severe cervical injuries occur between C1 and C4. These injuries require ventilator support and result in complete loss of function.
Thoracic injuries occurring between T1 and T12 specifically impact the trunk and the legs, but arm function is normally spared. These conditions lead to paraplegia. Slightly lower levels of lumbar and sacral injuries are associated with less impairment to the pelvic and leg functions, while higher levels cause more severe disabilities.
More severe cases of cervical injury are associated with major impairment and a considerable lifelong cost of care. These damages will always be awarded based on factors such as the age or prior earning capacity of an injured party.
The support of an attorney can make it much easier to calculate these losses and advocate for your right to fair compensation, according to Baton Rouge spinal cord injury lawyer Brian L. McCullough.
The American Spinal Injury Association Impairment Scale (AIS) is the global standard for assessing neurological damage resulting from spinal cord injuries. Under this system, damages are assigned one of five grades. The standards for each grade are listed below:
AIS A (Complete): The individual has lost all ability to sense or move body parts that connect to sacral segments S4 and S5.
AIS B (Sensory Incomplete): The individual can sense but not move body parts that exist below their S4 and S5 spinal cord damage.
AIS C (Motor Incomplete): Some limbs below the injury level can still be moved, but more than half of the muscles below the level of the injury have enough strength to be lifted against gravity.
AIS D (Motor Incomplete): The patient has an ability to move lower limb parts and possibly walk with one-half of the muscles below the level of injury. These muscles have a testing grade of 3 or higher, allowing them to move their body against gravity.
AIS E (Normal): The individual displays complete sensory and motor function. This grade is used when a patient had prior deficits and has recovered and it does not indicate that no injury occurred.
Medical professionals use AIS grades to determine patient health outcomes, while rehabilitation specialists use them to develop treatment plans, and legal experts need them for life care plans and court cases that address future medical expenses related to personal injury claims.
The medical system recognizes multiple clinical syndromes that define typical incomplete spinal cord injury patterns that result from different injury mechanisms and lead to different functional outcomes.
Central cord syndrome is the most common incomplete SCI pattern, which develops from hyperextension injuries among elderly patients who have existing cervical stenosis. The condition causes arm weakness that exceeds leg weakness. Patients with these conditions typically experience bladder control problems. Patients maintain their ability to walk, but they show severe functional problems with their arms and hands.
Brown-Séquard syndrome results when an individual sustains damage to one spinal cord side, which leads to motor loss and proprioceptive loss on the damaged side. The patient will also suffer from pain and temperature loss on the opposite side. The condition usually provides patients with good chances to regain their functional abilities.
Anterior cord syndrome causes damage to the front section of the spinal cord, which leads to motor loss. Patients lose the ability to feel pain and temperature below the injury point, but they can still perceive vibrations and body position. The pattern shows less favorable motor recovery results at all functional levels when compared to the central cord and Brown-Séquard patterns.
Cauda equina syndrome results from nerve root damage that occurs below the termination point of the spinal cord, leading to lower back pain, saddle anesthesia, and dysfunction in bladder, bowel, and sexual functions. Peripheral nerve root injuries show better chances of partial recovery when compared to true spinal cord injuries, which have the same functional impairment.
Spinal cord injury classification determines both financial outcomes and legal aspects of a case. Medical professionals assess the AIS grade, neurological level, and injury type to determine lifetime care expenses. These costs include all medical services needed for personal injury and medical malpractice legal cases.
The NSCISC 2025 report notes that indirect costs, including lost wages and productivity, averaged $95,309 per year in 2024 dollars for individuals with traumatic SCI. These costs are separate from direct medical costs that can reach into the millions depending on injury severity and life expectancy.
High cervical-level AIS tetraplegia exhibits the highest lifetime cost projections, while incomplete lower-level injuries show considerably reduced yet substantial cost estimates. Life care planning experts and vocational rehabilitation assessments establish these projections, which apply to particular cases instead of predetermined outcomes based on classification.
The experts form their opinions based on the underlying classification data. This data presents the factual foundation for their expert conclusions but does not determine any specific dollar value.
The classification of spinal cord injuries uses two main criteria that assess whether an injury is complete or incomplete based on retained sacral abilities and which neurological level determines the lowest spinal segment that shows full bilateral function.
The AIS system uses grades from A to E to evaluate various dimensions of assessment, which begin with complete injury at AIS A and end with full recovery at AIS E. Incomplete injury syndromes, including central cord, Brown-Séquard, anterior cord, and cauda equina syndrome, describe specific patterns of partial injury with distinct prognoses.
Medical professionals use injury classifications to assess lifetime care costs, lost earnings, and total damages in compensation claims.
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