By Michael Shemtoub, trial attorney, Beverly Law. Updated November 2026.
Spinal cord or back injury after an accident?
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A spine injury and a spinal cord injury are different things
The spine is the stack of bones and discs. The cord is the nerve tissue running through it. A broken vertebra or a herniated disc is a spine injury, and it becomes a spinal cord injury when the cord is damaged too. NINDS explains that the damage can come from a direct hit to the cord or from injury to the bones and tissue around it (NINDS).
Trauma is the usual cause, though not the only one. Mayo Clinic lists arthritis, cancer, inflammation, infection and disk degeneration as conditions that can also damage the cord (Mayo Clinic). If you are dealing with pain, numbness or a disc problem after a crash but your cord was not hurt, our pages on back and spine injuries after a car accident and herniated discs after a car accident fit your situation better.
Complete or incomplete
NINDS defines an incomplete injury as one where the cord can still send some messages to or from the brain, and a complete injury as one with no nerve communication below the injury site (NINDS). The formal test looks at the lowest segments of the cord, S4 and S5. Under the ASIA/ISCoS worksheet, any feeling or movement preserved at S4-5 makes the injury incomplete (ISNCSCI worksheet). So a person can have very little movement in the legs and still be classified as incomplete.
Most new injuries are incomplete. The National Spinal Cord Injury Statistical Center (NSCISC) at the University of Alabama at Birmingham reports this split of neurological categories for injuries since 2015, in its 2026 data sheet (NSCISC 2026):
| Neurological category | Share of cases |
|---|---|
| Incomplete tetraplegia | 47.7% |
| Incomplete paraplegia | 20.4% |
| Complete paraplegia | 19.6% |
| Complete tetraplegia | 11.8% |
| Normal | 0.4% |
Level: tetraplegia and paraplegia
The higher the damage, the more of the body it affects. Mayo Clinic describes tetraplegia (also called quadriplegia) as affecting the arms, hands, trunk, legs and pelvic organs, and paraplegia as affecting all or part of the trunk, legs and pelvic organs while sparing the arms (Mayo Clinic).
Neck injuries are the most common group. The NSCISC FAQ says about 55% of injuries are cervical, causing tetraplegia, and about 45% cause paraplegia: thoracic about 35%, lumbar about 10% and sacral under 1% (NSCISC FAQ). The FAQ cites the model systems’ 2023 annual report among its sources.
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The ASIA Impairment Scale, A to E
The American Spinal Injury Association and the International Spinal Cord Society publish the exam doctors use, the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), now in its 9th edition from 2026 (ASIA). The exam ends in an AIS grade. In plain terms, from the worksheet’s definitions:
| Grade | What it means |
|---|---|
| A, complete | No feeling or movement preserved at S4-5 |
| B, sensory incomplete | Some feeling below the injury level, including S4-5, but no movement preserved more than three levels below the motor level |
| C, motor incomplete | Some movement preserved below the injury level, but fewer than half of the key muscles below the injury reach muscle grade 3 or higher |
| D, motor incomplete | Movement preserved, and at least half of the key muscles below the injury reach grade 3 or higher |
| E, normal | Feeling and movement test normal in someone who had earlier deficits |
The worksheet adds that someone who never had a spinal cord injury does not get an AIS grade at all (ISNCSCI worksheet). The first grade is not always the last one. The Merck Manual notes that rapid swelling of the cord can cause total loss of function that looks like a complete injury at first (Merck Manual).
Common incomplete patterns
Some incomplete injuries follow recognizable patterns, which the Merck Manual describes (Merck Manual):
- Central cord syndrome usually follows a backward bending (hyperextension) injury in someone with a narrowed canal in the neck. The arms are weaker than the legs.
- Brown-Séquard syndrome comes from damage to one side of the cord. That side loses strength and position sense, while the opposite side loses pain and temperature feeling. StatPearls puts it at 1% to 4% of traumatic spinal cord injuries (StatPearls).
- Anterior cord syndrome follows injury to the front of the cord or its artery. Movement and pain feeling are lost on both sides, while vibration and position sense remain.
- Cauda equina lesions cause partial weakness or numbness in the lower legs, numbness in the saddle area, and bowel and bladder problems.
Warning signs that need emergency care
Mayo Clinic lists serious back or neck pain or pressure, weakness or loss of control in any part of the body, numbness in the hands or feet, loss of bladder or bowel control, trouble walking or breathing, and a twisted neck or back as emergency symptoms. It advises treating anyone with a head or neck injury as having a spinal injury, not moving the person, and calling 911 (Mayo Clinic). This page is general information. Only a doctor can tell you whether your cord was injured.
What this means for your case
The classification in your chart becomes part of the case. The level, the AIS grade and any change in that grade over time are what doctors, life care planners and the insurer look at when they project future care. Ask your providers for the full ISNCSCI exam results, and keep copies as the grade is updated. Our page on what a spinal cord injury case is worth explains how those records feed into damages, and the page on disability benefits for a spinal cord injury covers Social Security.
Deadlines run while you recover. The general limit to file an injury lawsuit is two years in California (CCP 335.1) and Texas (CPRC 16.003), and three years in Washington (RCW 4.16.080). A claim against a public agency can be due in six months in California (Gov. Code 911.2) and Texas (CPRC 101.101). Texas cases are handled by the firm’s Texas-licensed attorneys, Joyce Ondich and John Efstathiou. The steps are laid out in how to sue for a spinal cord injury.
Common questions
Is a herniated disc a spinal cord injury?
Usually not. A herniated disc is a spine injury. It counts as a spinal cord injury only if the disc or other damage injures the cord itself, which a doctor confirms with an exam and imaging.
Does a spinal cord injury have to cause paralysis?
No. An incomplete injury can leave strength in much of the body. AIS grade D, for example, means at least half of the key muscles below the injury reach muscle grade 3 or higher on the exam.
Can an incomplete injury improve?
Some people regain function, and the AIS grade can change over time. NSCISC reports that fewer than 1% of people had complete neurological recovery by the time they left the hospital (NSCISC 2026). Your own doctors are the ones to judge your outlook.
Can a spinal cord injury happen without a fall or crash?
Yes. Mayo Clinic lists arthritis, cancer, inflammation, infection and disk degeneration among nontraumatic causes. A legal claim depends on whether someone else’s conduct caused or worsened the injury.
Who decides my AIS grade?
A trained clinician performs the ISNCSCI exam, testing feeling and muscle strength at set points on both sides of the body. The grade comes from that exam. Beverly Law offers a free case review in English or Spanish at (310) 552-6959. You owe no fees or costs unless we win. More answers are in our injury law FAQs.
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Related pages
Sources
- NINDS, Spinal Cord Injury (ninds.nih.gov)
- Mayo Clinic, Spinal cord injury, symptoms and causes (mayoclinic.org)
- ASIA, International Standards for Neurological Classification of SCI (ISNCSCI) (asia-spinalinjury.org)
- ASIA/ISCoS, ISNCSCI worksheet (9th edition 2026) (asia-spinalinjury.org)
- NSCISC at UAB, Traumatic Spinal Cord Injury Facts and Figures at a Glance (2026 SCI Data Sheet) (sites.uab.edu)
- NSCISC at UAB, Frequently asked questions (sites.uab.edu)
- Merck Manual Professional Version, Spinal Trauma (reviewed May 2025) (merckmanuals.com)
- StatPearls (NCBI Bookshelf), Brown-Séquard Syndrome (ncbi.nlm.nih.gov)
- Cal. Code Civ. Proc. § 335.1 (leginfo.legislature.ca.gov)
- Tex. Civ. Prac. & Rem. Code § 16.003 (statutes.capitol.texas.gov)
- RCW 4.16.080 (app.leg.wa.gov)
- Cal. Gov. Code § 911.2 (leginfo.legislature.ca.gov)
- Tex. Civ. Prac. & Rem. Code § 101.101 (statutes.capitol.texas.gov)
Important: This page is general information, not legal or medical advice, and reading it does not create an attorney-client relationship. Every case is different; talk to a lawyer about yours. Texas cases are handled by the firm’s Texas-licensed attorneys, Joyce Ondich and John Efstathiou. Last reviewed: November 7, 2026.