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Complete C5 Vs Incomplete

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  • Complete C5 Vs Incomplete

    My 17 year-old son was injured Feb 10th and is now diangosed as a complete C5. I've been reading the resources to get an understanding of complete vs incomplete.
    He is able to wiggle his right thumb and is almost able to turn over his right arm. According to the drawing of injury sections, if he is complete, wouldn't that mean he shouldn't be moving the arm (which is C6)? I appreciate any advice. (Sorry if this was discussed in previous posts - too many to look thru.) Thanks!

  • #2
    c5 inc and complete can move both arms, but dont have triceps or wrist flexion or forearm muscles.
    Incomplete injury means that he either has feeling below the level of injury or can move any muscles below the level of injury.
    Its still too early to tell if he is comp or inc. it usually takes 2 years for the swelling of the spinal cord to go down
    Last edited by Mac85; 04-05-2012, 12:56 PM.
    C5/C6 Complete since 08/22/09

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    • #3
      He sounds incomplete.
      Can he feel pin pricks around his anus?

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      • #4
        This may help:
        http:///index.php?page=viewarticle&a...nalLevels.html

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        • #5
          My injury was at c4/5 and was incomplete...so my wrist extensors came back as did some muscle movement in my back and trunk...quite a bit of patchy sensation came back in areas too.
          Each injury is unique...but hopefully your son gets lots of recovery.
          C4/5 incomplete, 17 years since injury

          "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

          "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

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          • #6
            Originally posted by AJsMom View Post
            My 17 year-old son was injured Feb 10th and is now diangosed as a complete C5. I've been reading the resources to get an understanding of complete vs incomplete.
            He is able to wiggle his right thumb and is almost able to turn over his right arm. According to the drawing of injury sections, if he is complete, wouldn't that mean he shouldn't be moving the arm (which is C6)? I appreciate any advice. (Sorry if this was discussed in previous posts - too many to look thru.) Thanks!
            Don't confuse the dematome charts, which show the areas of skin sensation innervated by different SCI cord segments with the movements possible. For example, while C6 innervates sensation for the thumb and index finger, it does not innervate the muscles responsible for individual movement of those fingers (that is lower in the cord, at C8 and T1).

            It would be important to know what his actual ASIA exam shows as far as sensation and movement, and how those reflect on the name of the level of injury (LOI).

            For the key muscles evaluated in the ASIA exam, you must also have at least a muscle grade of 3 (out of 5) to consider that as an intact muscle. A 3 means that the joint the muscle controls can be moved voluntarily thorugh its entire range of motion, against gravity. A 2 would allow the joint to be moved through its entire range, but only with gravity eliminated (in specific positions). A 4 and 5 can do that but with varying degrees of ability to overcome resistance.

            Here are the key muscles. Other muscles are of course also evaluated, but only these are scored in the ASIA exam:

            Arm and Hand
            • C5 Elbow flexors (biceps)
            • C6 the wrist extensors (extensi carpi brevis and radialis)
            • C7 the elbow extensors (triceps),
            • C8 the finger flexors
            • T1 the little finger abductor (Movement of the little finger away from others).
            Leg and foot
            • L2 – hip flexors (psoas muscle)
            • L3 - knee extensors (quadriceps)
            • L4 the ankle dorsiflexors (anterior tibialis)
            • L5 the long toe extensors (hallucis longus)
            • S1 the ankle plantar flexors (gastrocnemius)
            In addition, the determination of being incomplete using the ASIA exam is dependent much more on sensation than on motor function. It would be critical at this point to know if he has any sensation right at his anus, since this is required to be ASIA B or better.

            The article linked above (by Dr. Young) is an excellent resource.

            Where is your son right now?

            Please come back and ask more questions. We are sorry you had to find us, but glad you did. We can help.

            (KLD)
            The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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            • #7
              I am so sorry to hear about your son. My son was injured in January and is a C6 incomplete. I have learned so much from this site and have read about people who were initially misdiagnosed as completes. Stay strong his injury is still so fresh and things can change rapidly.

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              • #8
                Thank you all for your responses. I have requested another meeting with his rehab team to get more info now that I now what I need to ask. My mind as been in a fog since the accident and just in the past week has started to clear up and focus.

                He is at Casa Colina in Pomona, CA. The current issue is the team is recommending a power wheelchair and A.J. is adamant he doesn't want a powerchair but wants a manual chair. He doesn't want to be different or "odd-looking" using his neck to move the chair. He'd rather be pushed. And of course, he shuts down and blocks out people when they attempt to discuss the long term possiblity of his being in a wheelchair.

                Thiis site is inspiring, reading through the stories and seeing all the support. I will be showing this site to A.J. today.
                Thank you!

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                • #9
                  If you are close to Carlsbad you might want to check out project walk or at some point it sounds like it would be right up your son's alley. SCI Fit is also in california im not sure whats closer to you.

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                  • #10
                    Originally posted by AJsMom View Post
                    Thank you all for your responses. I have requested another meeting with his rehab team to get more info now that I now what I need to ask. My mind as been in a fog since the accident and just in the past week has started to clear up and focus.

                    He is at Casa Colina in Pomona, CA. The current issue is the team is recommending a power wheelchair and A.J. is adamant he doesn't want a powerchair but wants a manual chair. He doesn't want to be different or "odd-looking" using his neck to move the chair. He'd rather be pushed. And of course, he shuts down and blocks out people when they attempt to discuss the long term possiblity of his being in a wheelchair.

                    Thiis site is inspiring, reading through the stories and seeing all the support. I will be showing this site to A.J. today.
                    Thank you!
                    I would be up front with him that YOU don't intend to spend all your time pushing him around in a manual wheelchair! He will need to be self mobile to go to school and do things with his friends. Ideally, he should have both a manual and power wheelchair, if your insurance will cover this. Go ahead and get the manual wheelchair ordered, which he MAY be able to push eventually, but also find out about getting the power chair. He may have enough recovery to use a joy stick eventually, so how he controls the power chair can change. A chair that can be later modified to accommodate these improvements would be ideal.

                    Casa Colina is a good center. Take advantage of everything they offer, including counseling. I assume he is still in school, so be sure to get information about an IEP for him as well.

                    The post-acute programs mentioned above are not a replacement for or appropriate for an acute inpatient rehab program, and should be investigated carefully prior to committing funds to private paying for a program such as that (insurance does not cover).

                    (KLD)
                    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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                    • #11
                      Originally posted by AJsMom View Post
                      Thank you all for your responses. I have requested another meeting with his rehab team to get more info now that I now what I need to ask. My mind as been in a fog since the accident and just in the past week has started to clear up and focus.

                      He is at Casa Colina in Pomona, CA. The current issue is the team is recommending a power wheelchair and A.J. is adamant he doesn't want a powerchair but wants a manual chair. He doesn't want to be different or "odd-looking" using his neck to move the chair. He'd rather be pushed. And of course, he shuts down and blocks out people when they attempt to discuss the long term possiblity of his being in a wheelchair.

                      Thiis site is inspiring, reading through the stories and seeing all the support. I will be showing this site to A.J. today.
                      Thank you!
                      At a c5 level AJ should be able to use a hand control on a power chair. The power chair will give him far more independence both indoors and outdoors. You can always buy a manual chair online to use also. Insurance usually only pays for one chair, power chairs can cost as much as 30 or 40 thousand dollars so let insurance buy the power chair. Project Walk in Carlsbad is an excellent facility to teach and motivate people. We travel there from Pennsylvania every year or so.

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                      • #12
                        I'm 9 months into my recovery from shattered c5, fused 456, function of c7, contusion to the spine, incomplete. Best advice I've gotten is take recovery as my own personal Olympics. I've been told I won't walk and all that. I won't give my goal of walking again and train everyday and get in my standee. You gotta put work in and hope for the best

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                        • #13
                          The order for A.J.'s (C5 on 2/10/12) wheelchair is being placed this Monday. He is insisting on a manual chair even though the therapists recommend power chair. He says the power chair will make him lazy & unmotivated. He is improving in his right arm movement but the left is still not really doing anything. You can see some flex in the muscle area, though. I'm afraid he is making a choice he will later regret but his dad supports his decision. A.J. just turned 18 so I don't have the final word over his care anymore. And advice you would give to A.J.?

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                          • #14
                            I would just let him know that this is his chance to get a power chair, and that he may not be able to get one in the future. Has he been outdoors or on any outings with recreation at the rehab center with a manual chair? Has he found how difficult it can be for someone at his level to get up a ramp, across uneven ground, etc. under his own power? Has his team given him these challenges to deal with?

                            I would also let him know that later when he wants to do things that involve these types of environmental challenges, you and other family members are very likely to not be available to push him around manually or accompany him on these outings, so he may end up missing out. This includes things like negotiating a college campus or work location as well as fun places to visit.

                            Don't let him just become homebound. This would be a disaster for a young man like this.

                            (KLD)
                            The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                            Comment

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