Spinal Cord Injury & Paralysis

A spinal cord injury can change movement, sensation, breathing, bladder and bowel function, and much of everyday life. No two injuries are alike, and changes over time differ from one person to the next. The injury alone does not show that anyone was at fault. A spinal cord injury lawyer looks at how the event happened, whether someone failed to act with reasonable care, and what the medical evidence shows about the injury and the care a person will need.

What a spinal cord injury is

The spinal cord is the bundle of nerves that carries signals between the brain and the rest of the body1. A spinal cord injury (SCI) is damage to that cord. It can come from a direct injury to the cord or from damage to the bones and tissue around it, and it can cause temporary or permanent changes in feeling, movement, strength and body functions below the injured area1. MedlinePlus notes that most injuries do not cut through the cord. More often, broken or displaced bone tears into the cord or presses on it3.

Doctors describe the spine in four regions. The nerves at each level serve different parts of the body1:

• Cervical (neck, C1 to C7): the back of the head, neck, shoulders, arms, hands and the diaphragm used for breathing
• Thoracic (upper and mid back, T1 to T12): chest muscles, some back muscles and many organ systems
• Lumbar (lower back, L1 to L5): the lower abdomen and back, buttocks and parts of the legs
• Sacral (S1 to S5): the thighs, lower legs and feet, most of the external genital organs and the area around the anus

In general, the higher the injury, the more of the body it affects. NINDS explains that an injury high in the cord can affect all four limbs, called tetraplegia or quadriplegia, while an injury lower down may affect only the lower body and legs, called paraplegia1.

Complete and incomplete injuries, and why the level matters

Doctors also describe how much of the cord's function is lost. With an incomplete injury, the cord can still send some messages, so a person keeps some feeling, function or muscle control below the injury. With a complete injury, there is no nerve communication below the injury site1. Paralysis may be present right away, or it may develop over time from bleeding, swelling and cell death in the cord1.

The standard exam is the International Standards for Neurological Classification of Spinal Cord Injury, often called ISNCSCI. It tests strength and sensation level by level and assigns a grade on the ASIA Impairment Scale (AIS)4:

The ASIA Impairment Scale in plain terms

AIS A, complete

No sensory or motor function is preserved in the lowest sacral segments, S4 to S54.

AIS B, sensory incomplete

Some sensation, but no movement, is preserved in the lowest sacral segments, with no motor function more than three levels below the motor level4.

AIS C and D, motor incomplete

The injury is incomplete and some movement is preserved further below it, either voluntary anal contraction or muscle function more than three levels below the motor level. In AIS C, fewer than half of the key muscle functions below the neurological level reach a strength grade of 3 or more; in AIS D, at least half do4.

AIS E, normal

Sensation and movement test as normal in a person who had earlier deficits4.

These grades describe the exam at a point in time. They are not a forecast. Data collected since 2015 by the federally funded SCI Model Systems centers show that incomplete injuries are now more common than complete ones, with incomplete tetraplegia the most frequent category5. NINDS notes that when an injury causes little or no nerve cell death, a person can make an almost complete recovery1, while other injuries cause lasting changes. Treating doctors are the right people to speak to any one person's outlook.

Spinal cord injury or another back, spine or nerve injury?

Not every serious back or neck injury is a spinal cord injury, and the difference shapes both treatment and a claim:

• A herniated disk happens when part of a disk pushes out of place. It may press on nearby nerves or the spinal cord and cause pain, numbness or weakness, which often improve over weeks to months6
• Radiculopathy is a problem with one or more of the nerve roots that branch off the cord6. A cord injury, by contrast, causes weakness and loss of feeling at and below the injury level2
• Below the first lumbar vertebra, the cord ends and becomes a bundle of nerve roots called the cauda equina. An injury there is not technically an SCI, but it can cause cauda equina syndrome, which can be an emergency that needs surgery right away2
• A broken vertebra can injure the cord, so after a spine injury doctors check movement and sensation at and below the injured area1

Imaging helps sort this out. NINDS explains that MRI can show spinal cord trauma, herniated disks, bleeding and ligament injury, CT can show fractures and narrowing of the spinal canal, and x-rays can show fractures and misalignment1. The neurological exam ties those findings to what a person can and cannot feel and move.

Common causes of spinal cord injury claims

Motor vehicle crashes and serious falls are the most common causes of SCI in the United States1. Model Systems data since 2015 attribute about 37% of new injuries to vehicle crashes and about 33% to falls5. Situations that may involve someone else's carelessness include:

• Car crashes, motorcycle crashes and truck crashes, including rollovers
• Falls from stairs, balconies, ladders or loading docks on poorly maintained property
• Diving into shallow water at a pool or lake with no depth markings or warnings
• Falls from scaffolds, roofs or lifts at construction and industrial sites
• Being struck by heavy objects, equipment or vehicles at work
• Assaults at properties with known security problems
• Surgical or medical events, which raise separate malpractice questions

MedlinePlus notes that even a minor injury can damage the cord when the spine is already weakened, and that most low-impact SCIs, such as from a slip and fall, happen in older adults with narrowing of the spinal canal that most of them did not know about2. An existing condition does not by itself rule out a claim. It does mean the medical history needs careful review. Our pages on premises liability and construction site injuries cover those settings in more depth. When a head injury is also involved, see traumatic brain injury.

Health effects beyond movement

NINDS and MedlinePlus describe effects well beyond paralysis that may need treatment12:

• Help with breathing
• Pneumonia risk
• Blood pressure and heart rhythm changes
• Blood clots
• Spasticity (muscle stiffness)
• Pressure injuries to the skin
• Nerve pain
• Bladder and bowel changes
• Changes in sexual function and fertility
• Depression

About one-third of people with an SCI need temporary or permanent help with breathing1. People with injuries at the neck or upper back can develop autonomic dysreflexia, a sudden rise in blood pressure that NINDS calls life-threatening1. Since 2015, about 29% of people with a traumatic SCI are re-hospitalized at least once in any given year after injury5.

Rehabilitation, assistive technology and daily life

Rehabilitation aims to build strength, skills and independence. NINDS describes a team usually led by a doctor specializing in physical medicine and rehabilitation, with physical and occupational therapists, rehabilitation nurses and psychologists, vocational counselors, social workers and others1. Depending on the injury, a person may use1:

• Braces, a wheelchair or assisted walking training
• Electronic stimulators and neural prosthetics
• Computer adaptations and other assistive technology for writing, typing and phone use
• Occupational therapy for getting in and out of bed, bathing, eating and using the toilet
• Vocational rehabilitation to find accessible work and the equipment needed to do it

Life at home may call for ramps, wider doors, an accessible bathroom, an adapted vehicle and help from family or paid caregivers. Work often changes too. Model Systems data show that 18% of people with a traumatic SCI since 2015 were employed one year after injury, and that the employment rate rises over time, peaking about 30 years after injury5. Rehabilitation also encourages classes, hobbies and community activities1.

How liability and causation are proven in a spinal cord injury lawsuit

A spinal cord injury lawsuit usually rests on negligence: a duty of reasonable care, a failure to meet it, and an injury caused by that failure. All three need evidence.

Arizona applies comparative fault. A person found partly at fault can still bring a claim, but damages are reduced by that share10. Other states handle shared fault differently, and in some states it can bar recovery altogether.

Work injuries follow their own rules. In Arizona, workers' compensation is generally the only remedy against an employer or co-worker, with a narrow exception for willful misconduct11. A claim may still be brought against someone outside the employer, such as a negligent driver, equipment maker or property owner12.

Who may be responsible for a spinal cord injury

Depending on what the evidence shows, a claim review may consider:

• A driver or the company that employed the driver
• A property owner, landlord or manager responsible for stairs, railings or lighting
• A pool, hotel or recreation operator, for depth warnings and supervision
• A general contractor or subcontractor responsible for site safety
• A manufacturer of a defective vehicle part, ladder, lift or safety harness
• A business that failed to provide reasonable security
• A public entity responsible for a road or public building, subject to strict notice rules

Medical evidence, functional assessments and future-care planning

The medical record does much of the work in a spinal cord injury claim. It shows what was injured, how the injury was graded and how function changed. Future needs are built from the person's own records, goals and circumstances, not from averages.

Records that help

The event

• Police, crash or incident reports
• Photos and video of the scene
• Witness names and statements
• Safety, inspection or maintenance records

Medical evidence

• Ambulance and trauma center records
• MRI, CT and x-ray reports
• Neurological exams and ISNCSCI or AIS grades
• Operative and rehabilitation records

Function and future care

• Therapy notes on mobility, self-care and daily tasks
• Equipment prescriptions and home-change quotes
• Work history and vocational assessments
• Caregiver logs kept by family members

Functional assessments from physical and occupational therapists show what a person can do safely and what help they need. A future-care plan, often prepared with input from treating doctors and rehabilitation specialists, sets out expected care, equipment, home changes and support. The plan should reflect the individual, and it may be updated as recovery and rehabilitation continue.

When to speak with a spinal cord injury lawyer

A legal review makes sense when a spinal cord injury followed a crash, fall, work incident or other event that someone else may have been able to prevent. A spinal cord injury attorney will usually want to know:

• How, where and when the injury happened
• Who owned, controlled or operated the vehicle, property or equipment involved
• What the first medical records say about the neurological exam
• Any earlier back or neck problems
• What insurance, workers' compensation or other coverage applies
• Which state's law applies and how much time remains

Filing deadlines for a spinal cord injury claim

Arizona generally requires a personal injury lawsuit to be filed within two years after the cause of action accrues7. When a city, county, school district or other public entity may be responsible, a notice of claim generally must be filed within 180 days, with a specific settlement amount and supporting facts8, and the lawsuit must generally be filed within one year9. For an injured worker with a claim against someone outside the employer, Arizona law can assign that claim to the workers' compensation carrier if suit is not filed within one year12.

Other states have different limits and exceptions. Hospital and rehabilitation stays can use up time quickly, so it helps to ask early. Our Arizona personal injury overview explains the wider claim process.

Tell Us Your Story →

A spinal cord injury changes how a person moves through the world, not who they are, and a claim should be built around that person's real needs.

What happens after you contact CBW Law

How a review works

1. You tell us what happened

   Tell us when and where the injury happened and how things stand now. Approximate dates are fine.

2. We gather records

   With your permission, we request incident, medical and rehabilitation records and look for photos, video and witnesses.

3. We review fault and causation

   We look at whether the evidence points to someone else's responsibility and how it connects the event to the injury.

4. We explain your options

   We tell you what we found, what questions remain and which deadlines apply.

Plain English

Medical, Health & Insurance

Spinal cord injury records and insurance papers use specialized terms. These are some you may see.

The injury

Tetraplegia (quadriplegia)

Paralysis that affects all four limbs and much of the body, from an injury high in the cord1.

Paraplegia

Paralysis that affects the lower body and legs, from an injury lower in the cord1.

Complete injury

No sensory or motor function in the lowest sacral segments, S4 to S54.

Incomplete injury

Some sensation or movement is preserved below the injury, including the lowest sacral segments4.

Cauda equina syndrome

Injury to the bundle of nerve roots below where the spinal cord ends2.

Exams and tests

ISNCSCI

The standard exam for classifying an SCI by testing strength and sensation at each level4.

AIS grade

The ASIA Impairment Scale grade, A through E, assigned after the ISNCSCI exam4.

Neurological level of injury

The lowest segment of the cord with normal sensation and normal strength against gravity on both sides of the body4.

MRI and CT

Imaging used to look for cord injury, disk injury, bleeding, fractures and canal narrowing1.

Health and rehabilitation

Autonomic dysreflexia

A dangerous rise in blood pressure that mainly affects people with neck or upper-back injuries1.

Spasticity

Muscle stiffness and increased muscle tone that can develop after an SCI1.

Pressure injury

Skin breakdown from steady pressure and reduced blood flow1.

Vocational rehabilitation

Services that identify work skills, accessible workplaces and needed equipment1.

Insurance and legal

Future-care plan

A written estimate of the care, equipment, home changes and support a person is expected to need.

Workers' compensation

Benefits for work injuries. In Arizona it is generally the only remedy against the employer11.

Third-party claim

A claim against someone other than the employer, such as a negligent driver or equipment maker12.

Notice of claim

A required written claim to an Arizona public entity, generally due within 180 days8.

Questions

Frequently asked spinal cord injury questions

Short answers to questions people and families ask after a spinal cord injury.

Is paralysis from a spinal cord injury always permanent?

No. Changes from an SCI can be temporary or permanent1, and NINDS notes that a person can make an almost complete recovery when there is little or no nerve cell death1. Other injuries cause lasting changes. Outcomes differ widely, and treating doctors are best placed to discuss any one person's outlook.

What is the difference between a complete and an incomplete spinal cord injury?

With a complete injury, there is no sensation or movement in the lowest sacral segments of the cord. With an incomplete injury, some sensation or movement is preserved there4. Since 2015, incomplete injuries have been more common than complete ones in SCI Model Systems data5.

My doctor said I have a herniated disk, not a spinal cord injury. Can I still have a claim?

Possibly. A herniated disk is a different injury that often presses on a nerve root and frequently improves over weeks to months6. A claim depends on what caused it and whether someone else was at fault, not only on the diagnosis. The medical records will show how serious it is.

I had back problems before the accident. Does that end my claim?

Not by itself. MedlinePlus notes that a weakened or narrowed spine can be injured by a smaller force2. A claim may still exist if the accident caused new damage or made an existing condition worse. Records from before and after the event help show the difference.

How is future care estimated in a spinal cord injury lawsuit?

It is built around the person, not an average. Treating doctors, therapists and rehabilitation specialists look at the injury level, current function, goals and home setting, and outline the care, equipment and support likely to be needed. We do not rely on generic cost figures.

I was hurt at work. Can I sue?

In Arizona, workers' compensation is generally the only remedy against your employer or co-workers11. You may still have a claim against someone outside your employer, such as another driver or an equipment maker12. Time limits for those claims can be short, so ask early.

How long do I have to file a spinal cord injury claim in Arizona?

Most personal injury lawsuits must be filed within two years after the cause of action accrues7. Claims involving public entities require a notice of claim within 180 days8 and a lawsuit within one year9. Other states set different deadlines, so it is best to ask early.

What if I was partly at fault?

In Arizona, a person found partly at fault can still recover, but damages are reduced by their share of fault10. Shared fault is a common argument in falls and crashes, so the evidence about how the injury happened matters. Other states may reduce or bar recovery under different rules.

Can a family member contact CBW Law for someone who is still in the hospital?

Yes. Families often reach out while a loved one is in acute care or rehabilitation, when there is little time for paperwork. We can start by gathering basic information about what happened and where. Decisions about a claim belong to the injured person or their legal representative.

Does CBW Law take every spinal cord injury case?

No. Some injuries happen without anyone being legally at fault, and some claims cannot be proven. We review the facts, the medical records and the law that applies, then tell you honestly whether we can help. Contacting us does not create an attorney-client relationship.

Tell Us Your Story

Spinal cord injuries differ in level, completeness and how they change over time, and a claim depends on what caused the injury and what the evidence shows about fault and future needs.

If you or someone close to you has a spinal cord injury after a crash, fall or work incident, tell us what happened. We will listen, look at the records with you and explain what a claim review could involve.

Tell Us Your Story →Call (800) 476-2416

This page is general information about spinal cord injury and paralysis. It is not legal or medical advice and does not create an attorney-client relationship. An accident, an injury or a loss does not, by itself, establish that anyone was negligent or legally responsible, and the law differs from state to state. No outcome can be promised in any case.