The Effects of a C6 Spinal Cord Injury on the Respiratory System

Many bodily functions can be impacted by a spinal cord injury (SCI) depending on the level and severity of the damage. As a general rule of thumb, the higher the impact occurs on the spinal cord — such as a cervical spinal cord injury — the more the injury will affect you (or someone you love with an SCI). For example, a C3 spinal cord injury or a C6 spinal cord injury will have a more significant impact on a patient than damage affecting the lumbar spinal cord region, such as an L3 spinal cord injury.

The cervical spinal cord, which is the topmost section of the spinal cord, consists of a series of nerves (C1-C8), which are identified to their corresponding cervical vertebral regions. According to the Shepherd Center, here is a breakdown of how different levels of spinal cord injuries affect respiratory function in patients with cervical spinal cord injuries:

  • C3 and Above: A ventilator is needed, the diaphragm is affected, and the ability to cough or sneeze is eliminated.
  • C4-C5: A ventilator may be needed some of the time, the patient retains partial diaphragm function, their abdominal and intercostal muscles don’t work, and their ability to sneeze or cough is eliminated.
  • C6-C8: The diaphragm is functional; however, the abdominal and intercostal muscles to not work.

According to Spinal Injury 101, also a resource of the Shepherd Center, a C6 spinal cord injury affects a variety of functions:

  • Affects wrist extension, though wrists can still bend back;
  • Results in paralysis in the hands, trunk, and legs;
  • Allows patients to speak and use their diaphragms, but results in weakened breathing;
  • Affects mobility, requiring assistive equipment to move in and out of wheelchairs and beds;
  • Affects the ability to drive; some patients may drive using an adapted vehicle; and
  • Significantly reduces or eliminates bladder and bowel function.

What are some of the common cervical spinal cord injury respiratory complications? And how, specifically, does a C6 spinal cord injury impact these functions?

How a C6 Spinal Cord Injury Impacts Respiration

People with injuries impacting the C6-68 levels of the spinal cord still can breathe on their own. However, in some cases, they may experience difficulty taking a deep breath and exhaling forcefully. The level and severity of each spinal cord injury vary significantly from one case to the next and contribute to determining the respiratory impact.

Here are some of the contributing factors to changes in respiration from a C6 spinal cord injury:

Spinal Cord Shock

Immediately following a traumatic SCI, especially a cervical spinal cord injury, a person with a spinal cord injury may experience what is known as spinal shock. This temporary condition, which can last for weeks to months, results in a loss of sensory and motor functions.

Immediately following their traumatic injuries, many C6 spinal cord injury survivors may require the use of a ventilator for a period of time. This differs from individuals with C1-C3 spinal cord injuries who are frequently ventilator-dependent and require the use of ventilators 24/7 to assist their breathing.

Loss of Muscle Control

The ability to contract and release the intercostal and abdominal muscles is eliminated in most cases of C6 spinal cord injuries. These muscles play a significant role in respiratory functions, as each muscle group is involved with the sequencing of contraction. When you take a breath (what is referred to as inspiration), the diaphragm and external intercostal muscles contract. When you exhale, your abdominal muscles contract, your internal intercostal muscles contract, and your external intercostal muscles relax.

According to content from Kendig & Chernick’s Disorders of the Respiratory Tract in Children, “patients with lower C5 to C6 spinal lesions can usually be weaned from the ventilator and do not have severe long-term respiratory impairment, despite alterations of intercostal and abdominal muscle function.”

Secondary Complications and Infections

Because a C6 spinal cord injury can affect your ability to exhale forcefully and cough, it means that airway aspirations may build up in the airways and lungs. Another contributing factor can be increased production of these bodily fluids. A buildup of these secretions can result in a variety of secondary conditions such as respiratory infections and lung congestion. It is recommended that individuals with limited cough capabilities use a cough-assist machine of some kind to help clear fluids from the lungs.

To help improve respiratory function and overall health after a C6 spinal cord injury, it’s vital to remain as physically active as possible. This may be accomplished through the use of activity based therapy (ABT) training and functional electric stimulation (FES) training. is an online community and resource for people living with spinal cord injuries and their families. We provide educational information, news about new and ongoing SCI research, and information, as well as information about a person’s legal rights after sustaining a spinal cord injury.

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Topics: Spinal Cord Injury, Treatment

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