If you or a loved one in California has suffered a spinal cord injury due to another person’s negligence or malpractice, remember that you are not alone. There is a wealth of resources, communities, and strong legal counsel available to help you cope, connect with others, and secure compensation to remedy the difficulties of your transition. If you’re ready to file your spinal cord injury lawsuit, we encourage you to contact our spinal cord injury lawyers today.
Spinal cord injuries (SCI) are among the most catastrophic injuries a person can endure. In an instant, an accident or medical mistake can leave you paralyzed or struggling with lost bodily functions. The complex nature of SCI adds to the weight of these changes, and understanding your prognosis, symptoms, and the specifics of your situation may feel like a challenge in itself. But with knowledge comes power, and learning about your injury and its legal implications can be the first step towards building an empowered life after SCI.
One thing to understand about your condition is the different levels of spinal cord injury. The “level” of an SCI refers to the segment of your spinal cord that was damaged, bruised, or severed (ranging from the high cervical vertebrae in the neck down to the sacral region in the lower back). This only predicts the potential physical challenges ahead but also influences the legal strategy and compensation for your case.
In this article, we break down the different types and levels of spinal cord injury and explain what they could mean for your personal injury or medical malpractice claim.
Complete vs. Incomplete Spinal Cord Injuries
When it comes to understanding your injury, the first distinction to make is whether or not your spinal cord injury is complete or incomplete. All spinal cord injuries fall into one of these 2 categories.
A few days after your accident, your doctor should perform a complete neurological examination, testing your muscle strength and sensory abilities below the site of the injury. They can also use X-rays, MRIs, or other devices to visualize the damage to your spinal cord. They can compare your injury to many others they have seen. They’ll tell you what they think will happen, and what might not happen. While doctors are not always certain what your outcome will be, they should be able to give you a good idea of what you are facing.
With thorough examinations, imaging technology, and their best discretion, doctors will formally grade your spinal cord injury using the ASIA Impairment Scale (AIS). This allows them to determine if your SCI is complete or incomplete.
Complete Spinal Cord Injury
A complete spinal cord injury means that there is a total loss of sensation and motor control below the level of injury. Your brain is unable to send or receive signals through the damaged vertebrae, causing a loss of all feeling and mobility below the affected area. This often results in complete paralysis of certain bodily regions (quadriplegia or tetraplegia), depending on the specific level of the injury. Complete spinal cord injuries are represented by Grade A on the ASIA Impairment Scale.
Incomplete Spinal Cord Injury
An incomplete spinal cord injury means some amount of sensory or motor function remains below the injury level, called partial paralysis. The survivor might still be able to move and feel in some areas below their injury, and some abilities may recover with proper treatment. Incomplete injuries come in varying degrees and are graded B through D on the ASIA Scale.
Each case of SCI–especially incomplete injuries–is truly unique, and one individual might retain mobility in one limb or feel touch in unique areas, while another person with the same “level” of injury might have more substantial function throughout their body. Importantly, patients with incomplete SCIs generally have a better chance of regaining some function over time compared to those with complete injuries. With quality rehabilitation, many people see improvements in the first 6-12 months after injury, Recovery often plateaus after 1 year, but this is not always the case.
Legal Considerations
From a legal perspective, the completeness of your spinal cord injury will influence the scope of your lawsuit in terms of compensable damages. These “damages” can include everything from medical expenses, diminished quality of life, loss of income, and the pain and suffering that come with paralysis. These factors will be quantified in monetary terms during your case, as tangible amounts of money owed to you after being injured by someone else’s negligence or reckless actions.
Complete injuries often imply permanent, life-altering disability, which will increase the potential damages due to the need for attentive care and the total loss of certain abilities. An incomplete injury still involves significant disruption to the victim’s life, but there is typically a lesser need for lifelong, intensive care, and one’s disabilities are not as all-encompassing. Remember, however, that these are only the general rules, and every survivor of SCI is in a unique position that warrants hope and individual consideration.
In either scenario, California law allows you to seek compensation for the full extent of your losses and future expenses. The right attorney will have a proven track record of maximizing compensation in cases like yours, ensuring that you receive the care you need for optimal recovery and quality of life.
(To give you a rough idea of a baseline for damages: data from the National Spinal Cord Injury Statistical Center shows that the average first-year expenses for SCI survivors range from $447,037 to $1,369,755 for healthcare and cost of living alone, depending on the level of injury).
Predicting Potential Outcomes
Before diving into the different levels of spinal cord injuries and what they might entail for your legal claim, let’s make a few things clear: prediction is not destiny. Keep in mind that your situation is unique and may not fit the usual pattern. You could recover much better than expected. There is also a chance your recovery might not meet your doctors’ outcome expectations.
A “complete injury” may not be so complete. The medical field has always defined complete spinal cord injury as lacking motor or sensory function below the level of injury, but that’s not the whole story. Recent experiments with spinal cord stimulation have shown that a group of paraplegics considered ASIA Grade A–complete paralysis and numbness–were able to initiate voluntary movement in paralyzed limbs, and were also able to control bladder and bowel function. Stimulation appears to awaken nerve circuits in the spinal cord that are intact but dormant. These circuits then reactivate movement patterns programmed into the cord. There’s more vitality in the injured spinal cord than previously thought.
There is usually hope for at least a little improvement after a spinal cord injury, but even with the
most sophisticated tools, no one can predict your future. Even measured on the first day or two post-injury, outcome predictions are fairly reliable, though not infallible.
Here are a few bullet points to consider before reading about the prognosis and legal implications of each SCI level:
- Generally, those with a complete injury (no muscle power or sensation below the injury) regain one or two levels of function.
- About 80 to 90 percent of those with complete injuries will usually remain complete, not 100 percent.
- The majority of those with motor incomplete injuries recover some ability to walk.
- If improvement continues, such as increasing muscle movement, chances for more improvement are usually better.
- Those with an incomplete injury (some muscle or sensory function below the injury) are more likely than those with a complete injury to regain movement.
- Younger people generally recover more than older people.
- There is no sure way to know how much function will return. Stay optimistic.
By balancing hope with expectation management, and keeping an open mind, you (like many survivors) can prepare yourself for a fulfilling (albeit different) life ahead. Read on to learn more about the specifics of spinal cord injury and potential outcomes.
SCI Levels by Region
The different levels of spinal cord injuries are classified by the region of the spine that is damaged, and further distinctions are made by referencing the individual vertebrae (or groups of vertebrae) affected. The spinal cord is divided into four main regions:
- Cervical: The neck region (C1–C8)
- Thoracic: The upper back (T1–T12)
- Lumbar: The lower back (L1–L5)
- Sacral: The pelvic area (S1–S5)
Generally, the higher the injury on the spine, the more extensive the paralysis and loss of function. Each region of the spinal cord controls different body parts, so understanding the different levels helps predict what abilities or sensations a person with SCI may lose.
Higher injuries (in the cervical spine) lead to paralysis in more areas, epitomized by quadriplegia which affects all four limbs and the torso. Lower injuries (lumbar or sacral) may only impact the lower body and bodily functions like bowel movement, bladder control, and sexual function. Estimated medical costs increase with the severity and level of injury, with high cervical injuries often incurring lifetime care expenses well into the seven figures. These medical and financial variables directly influence the scope of legal claims after a catastrophic spinal injury.
Levels of Spinal Cord Injury and Their Legal Implications
Here are summaries of outcome expectations (remember, these are general outcomes, based on a large number of patients. They are not immutable facts regarding your injury). People with incomplete injuries are especially variable, and therefore hard to categorize across all measures of function. Much of this data comes from the Consortium for Spinal Cord Medicine, which publishes authoritative, peer-reviewed clinical practice guidelines for spinal cord injury.
Cervical Spinal Cord Injuries (Neck, C1–C8)
Cervical spinal cord injuries are the most severe. Damaging or severing vertebrae high in this region can cut off communication to nearly the entire body below the neck. Cervical SCIs typically cause quadriplegia (also called tetraplegia), meaning paralysis of all four limbs and the torso.
Level C1-3
This is the highest level of spinal cord injury; it involves total paralysis of the trunk, arms, and legs. Most likely, these injuries will require assisted breathing with mechanical ventilation and typically need 24-hour care for daily activities, including bowel, bladder, bed mobility, transfers, eating, dressing, grooming, bathing, and transportation. Caregivers may need to use a mechanical lift with a sling. People with high-level injuries can power an electric wheelchair using sip-and-puff devices and manage independent communication with the right equipment.
Level C4
This level of injury involves full-body paralysis with some neck and shoulder movement. People with these injuries are usually able to breathe without a ventilator. Total assistance is generally needed for eating, bathing, and all personal care needs. For mobility, survivors of C4 injuries rely on power wheelchairs with sip-and-puff systems or chin controls.
Level C5
This is the most common level of spinal cord injury. People at this level usually retain shoulder, bicep, and elbow flexion but have weak or immobile hands and wrists. Many C5s use hand splints and may require assistance for grooming, transfers, and dressing. Some can drive adapted vehicles.
Level C6
People with this injury are generally more independent than those with higher injuries but still require assistance with certain tasks. Some help may be needed for bowel management, transfers, and bathing. Wrist flexion and hand movement are impaired. Driving an adapted vehicle is possible. People with C6 motor level can use tenodesis grip to enhance their ability to perform basic tasks and control objects.
Level C7/8
These individuals have greater arm and hand dexterity, including elbow, wrist, and thumb extension. Many can grasp and release objects and perform most daily activities independently with some adaptations. They are mostly independent for bladder and bowel self-care, transfers, eating, and grooming, but may require some assistance for daily activities. Overall, lower cervical injuries result in paralysis of the legs and trunk (paraplegia below the chest), but with varying arm and hand mobility.
Legal Implications of C-Level Injuries
From a legal standpoint, cervical SCIs are typically considered catastrophic injuries, which greatly increases the stakes of any personal injury or medical malpractice case. The lifetime costs associated with high cervical paralysis are enormous. Medical studies show that a 25-year-old with a C1–C4 injury may face over $6 million in long-term care costs and modifications. These costs, plus lost wages, loss of earning potential, and fringe benefits make up the economic damages that your lawyer can secure for you.
Additionally, the non-economic damages in a C-level SCI case are substantial. Survivors have lost their mobility, their independence, and often their ability to do basic life activities without assistance. Juries recognize that a person with quadriplegia endures a profound loss, and verdicts or settlements often reflect that. In California, SCI cases that do not involve medical malpractice have no cap on non-economic damages and can reach millions of dollars.
If the cervical injury was caused by medical malpractice (such as a surgical error, a delayed diagnosis, and other errors), California’s Medical Injury Compensation Reform Act (MICRA) comes into play. MICRA places a cap on non-economic damages in malpractice cases, which has historically been $250,000. As of 2025, this limit has increased to $430,000 for non-fatal cases, and $600,000 for wrongful death cases.
Thoracic Spinal Cord Injuries (Upper Back, T1–T12)
Thoracic spine injuries occur in the mid-back region. The thoracic vertebrae (T1 through T12) correspond roughly to the chest and abdominal areas. A spinal cord injury here usually results in paraplegia, affecting the legs and lower body, but with normal function of the arms and hands.
Level T1-9
This level involves lower trunk paralysis and somewhat limited trunk stability but full arm and hand function. Individuals are generally independent for daily activities, including wheelchair management, work, school, and homemaking. A T1 injury, which is just below the cervical spine, will cause paraplegia with the arms and hands unaffected. However, the T1 vertebra contributes to the nerves that control the fingers, so some finger movement may be impacted.
Level T10-T12
At the lowest levels of the thoracic spine, individuals typically experience paralysis of the legs, but their trunk stability and core strength are significantly better than those with higher injuries. Survivors generally have good sitting balance and may stand or walk short distances with braces or crutches. Most personal care tasks can be done without extensive assistance, but bowel and bladder function is typically impaired.
Legal Implications of Thoracic-Level Injuries
Thoracic spinal cord injuries are serious, life-altering conditions. While less severe than cervical injuries, the financial and emotional toll is still significant. A paraplegic person will incur heavy expenses in the first year (acute hospitalization, possible surgery, inpatient rehab, etc.), which according to national SCI data can average around $667,000 in the first year post-injury. Each subsequent year of living with paraplegia can add roughly $88,000 in medical expenses and living costs related to the injury, and over a lifetime, a 25-year-old person with paraplegia might face around $3 million in direct costs due to the injury (not including lost wages).
Adding non-economic damages to the cost of lifelong care and support, T-Level spinal cord injuries can command massive compensation. Although thoracic injury survivors may retain independence in their upper bodies, losing leg function profoundly impacts personal identity, relationships, and daily enjoyment. Experienced attorneys can communicate the full scope of these losses effectively, ensuring fair compensation.
Lumbar and Sacral Spinal Cord Injuries (L1–S5)
Lower spinal cord injuries typically affect mobility and functions from the hips downward. The lowest of these injuries will only result in paralysis and loss of sensation in the knees, ankles, feet, and toes. While these injuries are severe, they generally allow greater independence and mobility than higher injuries.
Levels (L1–L5)
Lumbar spinal cord injuries usually result in partial or complete paralysis of the hips, legs, and feet. People with these injuries often maintain full upper-body strength and trunk control. Depending on the precise level and severity, many can walk short distances using braces, walkers, or canes. Wheelchairs may be used primarily for longer distances or convenience. Bowel, bladder, and sexual functions are often compromised, requiring adaptive adaptive strategies and ongoing medical management.
Levels (S1–S5)
Sacral spinal injuries involve partial paralysis of the legs, hips, knees, ankles, and feet. Individuals are mostly independent and may ambulate with braces, crutches, or a cane. Major complications typically involve loss of bowel and bladder control and sexual dysfunction. Adaptive methods and medical interventions can significantly enhance independence, and survivors frequently resume most daily activities with minor accommodations.
Legal Implications of Lumbar and Sacral Injuries
While lumbar and sacral injuries might initially seem less catastrophic, the associated lifelong medical and personal challenges remain considerable. The ongoing costs related to adaptive equipment, physical therapy, and specialized medical care can be substantial. Vocational impacts must also be carefully considered—particularly for people whose livelihoods or professions depend on physical abilities. People who suffer L1-S5 injuries may face hundreds of thousands of dollars in first-year healthcare expenses, and potentially millions in lifelong care, but the range of potential damages is wide.
Non-economic damages for these lower-level injuries reflect the personal and emotional hardships experienced by survivors. Incontinence and loss of sexual function can dramatically alter a survivor’s quality of life, relationships, and psychological well-being. A qualified spinal cord injury lawyer can make sure these difficulties are accounted for in your claim.
Move Forward with Hope and Legal Support
In California and everywhere, survivors of SCI have a challenging road ahead, but there is always reason for hope. Advances in medical technology and rehabilitation therapies continue to improve outcomes and quality of life. Just as importantly, comprehensive legal support is available to ensure survivors have the resources necessary to thrive despite their injuries.
Don’t forget: plenty of people ahead of you went from walking to paralyzed in the same blink of an eye you know all about. The most important message is to get connected to people who have been where you are, and who have found ways to reinvent themselves. They’re not the same as they were before, but they have come to terms with the way things are, and they are OK. They are just as important as having strong legal counsel, and they can help you.
At Stalwart Law Group, our spinal cord injury attorneys are passionate about justice, for every case. We understand the physical, medical, and legal complexities of your injury, and we are ready to fight for your right to maximum compensation, covering medical expenses, pain and suffering, and the specialized care you deserve. If you or a loved one has suffered a spinal cord injury due to another’s negligence, contact us today for a free consultation. Together, we can take the first steps toward justice, financial security, and a brighter future.