Quadriplegia and Tetraplegia

The term Quadraplegic is derived from two different words from two different languages, Latin and Greek. The word “Quadra”, when translated from latin means “four”, this relates to the number of limbs. “Plegic”, is derived from the Greek word “Plegia”, which when tanslated, means "paralysis".

When the two words are combined together, you have “Quadraplegia”.

“Tetra” is derived from the Greek word for “Four”. “Para” is derived from the Greek word for "two" Hence: Tetraplegic and Paraplegic.

In Europe, the terminology for 4 limb paralysis has always been tetraplegia. The Europeans would never dream of combining a Latin and Greek root in one word.

Quadriplegic and Quadriplegia are the terms used mainly in America to describe paralysis of all four limbs. In 1991, when the American Spinal Cord Injury Classification system was being revised, the difference in names was discussed. The British are more aware of Greek versus Latin names. Since Plegia is a greek word and quadri is Latin, the term quadriplegia mixes language sources.

Upon review of the literature, it was recommended that the term tetraplegia be used by the American Spinal Cord Association so that there are not two different words in English referring to the same thing.

Quadriplegia / Tetraplegia

Quadriplegia or Tetraplegia is when a person has a spinal cord injury above the first thoracic vertebra (T1), paralysis usually affects the cervical spinal nerves, C1 to C8 resulting in paralysis of all four limbs. This may result in partial or complete paralysis of the arms as well as complete paralysis of the legs.

There are 7 cervical vertabrae in the neck, but 8 spinal nerves as the spinal nerves exit the spinal cord above the vertabrae.

In addition to the arms and legs being paralyzed, the abdominal and chest muscles will also be affected resulting in weakened breathing and the inability to properly cough and clear the chest. Breathing will be dependant on the diaphragm, or in severe cases, a ventilator. People with this type of paralysis are referred to as Quadriplegic or Tetraplegic.

Level of injury (Lesion)

The level of injury, otherwise known as a lesion, is the exact point in the spinal cord at which damage has occurred. Damage may take the form of scar tissue, or the cord may be compressed due to a damaged vertabrae or intervertabral disc. The levels of spinal nerves are determined by counting the nerves from the top of the spine downwards, and these nerves are grouped into four different area’s. These are the Cervical, Thoracic, Lumbar and Sacral parts of the spinal cord.

These area’s are important, as damage to the spinal cord at these points directly determines how groups of muscles, organs and sensations will be affected.

Determining how the spinal cord has been damage is also a consideration when evaluating a spinal cord injury. There are two types of lesion, these are a complete injury and an incomplete injury. Someone with a complete injury will have a complete loss of muscle control and sensation below their level of lesion. An incomplete injury is where maybe only the muscles have been paralyzed, or where there is impaired sensation.

Functionality after a Spinal Cord Injury

The functionality of a persons body following a spinal cord injury, will depend on the level of injury, and whether the injury was complete of incomplete. In order to show what functionality will be possible following a complete spinal cord injury, we have put together the most common abilities for varying degree's of paralysis. The age and weight of a person will also have a negative factor on the person's abilities.

Click the spinal levels below for a comparison of injury levels and abilities.

C1 - C3 : C4 : C5 : C6 : C7 - C8 : T1 - T4 : T5 - T9 : T10 - L1 : L2 - S5
These abilities are not definitive, and slight variations may be present.

Incomplete Spinal Cord Injuries

Anterior Cord Syndrome: is when the lesion is towards the front of the spinal cord, this can leave a person with the loss or impaired ability to sense pain, temperature and touch sensations below their level of injury. Pressure and joint sensation may be preserved. It is possible for some people with this injury to later recover some movement.
Central Cord Syndrome: is when the lesion is in the centre of the spinal cord. This typically results in the loss of function in the arms, but some leg movement may be preserved. There may also be some control over the bowel and bladder preserved. It is possible for some recovery from this type of injury, usually starting in the legs, gradually progressing upwards.
Posterior Cord Syndrome: is when the lesion is towards the back of the spinal cord. This type of injury may leave the person with good muscle power, pain and temperature sensation, however they may experience difficulty in coordinating movement of their limbs.
Brown-Séquard syndrome: is when lesion is towards one side of the spinal cord. This results in impaired or loss of movement to the injured side, but pain and temperature sensation may be preserved. The opposite side of injury will have normal movement, but pain and temperature sensation will be impaired or lost.
Cauda equina lesion: The Cauda Equina is the bundle of nerves which spread out of the spinal cord at between the first and second Lumbar region of the spine. The spinal cord ends at L1 and L2 at which point a bundle of nerves travel downwards through the Lumbar and Sacral vertebrae. Injury to these nerves will cause partial or complete loss of movement and sensation. It is possible, if the nerves are not too badly damaged, for them to grow again and for the recovery of function.

Support : Types of Paralysis : Vertebral Column : Spinal Cord : Myotomes & Dermatomes : Autonomic Dysreflexia : Spasticity & Spasms : Temperature Regulation : Respiratory System : Pressure Sores : Spinal Cord Injury Research