Changes in respiratory structure and function after traumatic cervical spinal cord injury: observations from spinal cord and brain

Respiratory problems and death are major concerns following severe cervical spinal cord injury (CSCI), mainly due to issues with breathing pathways and a paralyzed diaphragm. This review explores the anatomy and physiology of typical respiratory centers, explores alterations in respiratory function following spinal cord injuries, and delves into the structural foundations of modified respiratory function in patients with CSCI. Additionally, we propose that magnetic resonance neuroimaging holds promise in the study of respiratory function post-CSCI. By studying respiratory plasticity in the brain and spinal cord after CSCI, we hope to guide future clinical work.

• 1
  Following CSCI, patients may experience shallow and rapid breathing to maintain minute ventilation, but tidal volume tends to decrease under these circumstances.
• 2
  The regenerative capacity of axons is influenced by the distance between the injury site and the cell body. In the case of CSCI, the corticospinal tract has a lower potential for axonal regeneration compared to the bulbospinal tract
• 3
  Early improvements in respiratory function after SCI may be due to early edema subsidence, compensatory respiratory strategies, and altered respiratory muscle biomechanics.