Complete C5 Spinal Cord Injury: Functional Impairments & Care Needs

A complete C5 spinal cord injury (ASIA A) results in total loss of motor and sensory function below C5. This is a life-altering condition requiring comprehensive, lifelong care.

Functional Impairments

• Motor: Paralysis of trunk, legs, wrists, hands, fingers. Preserved: Shoulder (deltoid), elbow flexion (biceps), elbow extension (triceps weak/absent).
• Sensory: Absent below C5 dermatome.
• Respiratory: Diaphragm (C3–5) partially/fully paralyzed → ventilator dependence likely; impaired cough → pneumonia risk.
• Autonomic: Neurogenic bowel/bladder; autonomic dysreflexia (T6+); orthostatic hypotension; impaired thermoregulation.
• Upper limb function: Tenodesis grasp possible (wrist extension → passive finger flexion) with training/splints.

Complications

• Pressure injuries (insensate skin)
• Recurrent UTIs, renal calculi
• Spasticity, neuropathic pain
• DVT/PE, osteoporosis
• Depression, adjustment disorders

Rehabilitation & Assistive Technology

• Power wheelchair with chin/head array or sip-and-puff
• Environmental control units (voice/switch)
• Adaptive devices for feeding, grooming, communication
• Functional electrical stimulation (FES) cycling, hand systems
• Ventilator weaning protocols (if partial diaphragm function)

Life Expectancy & Quality

Near-normal life expectancy with expert care. Community integration, employment, relationships achievable with adequate resources and support.