Neurologic deficits in spinal cord injury

Level of Lesion	Neurologic findings
Level of Lesion	Motor*	Sensory level	Reflex*
Cervical
C2	Facial muscles, apneic	Occiput	No upper or lower extremity reflex
C3	Facial muscles, apneic	Thyroid cartilage	No upper or lower extremity reflex
C4	Spontaneous breathing	Suprasternal notch	No upper or lower extremity reflex
C4	Spontaneous breathing	Posterior neck	No upper or lower extremity reflex
C5	Shrugging and external rotation of shoulders	Below clavicle	Biceps present, remainder absent
C5	Shrugging and external rotation of shoulders	Middle deltoid	Biceps present, remainder absent
C6	Elbow flexion Wrist extension	Thumb	Biceps and brachioradialis present, remainder absent
C7	Elbow extension	Index and middle fingers	Triceps and above present, remainder absent
C7	Wrist flexion	Index and middle fingers	Triceps and above present, remainder absent
C8	Finger flexion	Small finger and ulnar side of hand	Triceps and above present, remainder absent
Thoracic
T1 - T12	Intercostal and abdominal muscles		Upper extremity present, lower extremity absent
T4		Nipple line	Upper extremity present, lower extremity absent
T10		Umbilicus	Upper extremity present, lower extremity absent
Lumbar
L1	Intercostal and abdominal muscles	Femoral pulse	Upper extremity present, lower extremity absent
L1 - L2	Hip flexion		Upper extremity present, lower extremity absent
L2 - L3	Hip flexion	Medial thigh	Upper extremity present, lower extremity absent
L3	Hip adduction		Upper extremity present, lower extremity absent
L4	Hip abduction	Knee	Patellar present, Achilles absent
L5	Foot dorsiflexion	Lateral calf	Patellar present, Achilles absent
Sacral
S1	Foot dorsiflexion	Lateral foot	Achilles and above present
S1 - S2	Foot plantar flexion		Achilles and above present
S2 - S4	Rectal sphincter tone	Perianal region	Achilles and above present

* Level of injury is at or above the given location.

Adapted from:

Rosen P, Barkin R, Danzl DF, et al. Emergency Medicine: Concepts and Clinical Practice, 4th ed, Mosby-Year Book, St. Louis 1998. p.481
Tachdjian MO. The neck and upper limb. In: Clinical Pediatric Orthopedics: The Art of Diagnosis and Principles of Management. Appleton and Lange, Stamford 1997. p.263.

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Neurologic deficits in spinal cord injury