A complete cervical spinal cord injury is a severe neurological injury affecting the spinal cord in the neck, causing loss of motor and sensory function below the level of injury. The resulting impairment is known as tetraplegia and may affect the arms, trunk, legs and autonomic functions. This guide explains diagnosis, treatment, specialist rehabilitation and the longer-term journey towards functional independence.
Road traffic collisions, falls, sporting or diving accidents, workplace injuries and other major trauma
Paralysis and loss of sensation below the injury, with possible breathing, bowel, bladder, sexual and autonomic dysfunction
Neurological examination using the International Standards for Neurological Classification of Spinal Cord Injury, with CT and MRI imaging
Spinal protection, respiratory and cardiovascular support, surgery where indicated and prevention of secondary complications
Specialist multidisciplinary spinal cord injury rehabilitation, including physiotherapy, occupational therapy, nursing, psychological and vocational support
Highly individual; functional potential depends particularly on neurological level, associated injuries, complications and response to rehabilitation
Respiratory problems, pressure ulcers, infection, spasticity, pain, autonomic dysreflexia, orthostatic hypotension, blood clots and bowel or bladder complications
Recovery after a complete cervical spinal cord injury requires early specialist spinal cord injury care and coordinated multidisciplinary rehabilitation. Although neurological recovery may be limited, substantial gains in independence, health, participation and quality of life can be achieved through rehabilitation, equipment, assistive technology and effective long-term management.
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Spinal protection, respiratory and cardiovascular support, neurological assessment, surgery where required and prevention of early complications
Early mobilisation when medically appropriate, positioning, pressure care, joint movement, respiratory rehabilitation and assessment of functional needs
Increasing participation in specialist rehabilitation, wheelchair skills, transfers, self-care, bowel and bladder management and assistive technology
Development of independence or assisted independence, physical conditioning, community access and detailed discharge planning
Continued functional gains, adjustment to home and community life, equipment refinement and vocational or educational rehabilitation
Lifelong specialist follow-up, health maintenance, management of complications and review of changing functional goals
Neurological recovery is generally greatest during the earlier months, but functional improvement can continue considerably longer through rehabilitation, adaptation and experience.
Complete cervical spinal cord injury is also commonly referred to as complete cervical SCI, complete tetraplegia, complete quadriplegia, cervical cord injury or complete spinal cord injury of the neck.
No. Complete describes the findings on neurological examination, specifically the absence of sacral sensory and motor function. Some neurological change can occur, particularly early after injury, although substantial recovery below a persistently complete injury is less likely than after an incomplete injury.
This depends mainly on the neurological level. Higher cervical injuries can severely restrict arm function, whereas lower cervical injuries may preserve shoulder, elbow or wrist movements that can be developed functionally during rehabilitation.
A person with a persisting neurologically complete cervical injury will usually require a wheelchair for mobility. Whether a manual or powered wheelchair is appropriate depends on arm function, posture, endurance, environment and individual needs.
Specialist inpatient rehabilitation commonly extends over months rather than weeks, particularly after higher cervical injuries. Rehabilitation continues after discharge as functional goals, equipment and circumstances evolve.
Some people return to previous or alternative employment, education or other meaningful roles. Vocational rehabilitation, assistive technology, workplace adaptations, transport and flexible working arrangements can help maximise opportunities.
Spinal cord injury changes the long-term management of several body systems. Specialist review helps prevent and manage complications involving skin, breathing, bladder, bowel, pain, spasticity, cardiovascular health and other consequences of spinal cord injury.
In complete cervical spinal cord injury, neurological recovery is only one measure of rehabilitation outcome. Meaningful progress may instead involve improved wheelchair mobility, greater independence in self-care, reliable management of bowel, bladder and skin health, effective use of technology or successful return to family, community and vocational roles.
The neurological level of injury provides an important framework for rehabilitation, but goals should remain individual. Early specialist input, prevention of avoidable complications and coordinated rehabilitation can preserve health and maximise functional potential, while continuing review allows rehabilitation strategies to adapt throughout life.
For more detailed information about this injury, its treatment and recovery, download the full Medicess Rehabilitation Guide.
If you’re unsure about your recovery or what support you may need, request a FREE Clinical Review.
Our clinical team will review your circumstances, help you understand options may be available and how we can support you.
Medicess works with solicitors, insurers and employers to provide rehabilitation case management support following serious injury.
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People interested in this injury also find the following related rehabilitation guides useful:
You may also wish to explore some of the organisations and publications that informed this guide.