The primary risk to the respiratory system after SCI occurs when the injury impedes the ability to independently breathe, swallow, or cough. The higher the injury, the more likely it is that a patient will experience breathing difficulties that necessitate the use of artificial respirators. These breathing devices are themselves a risk factor for respiratory infections since the equipment can become infected with dangerous bacteria.

Even if the spinal cord injury is low enough that you're able to breathe on your own, you may still experience changes in your respiratory system. You'll likely be getting less exercise, which means your lungs and heart may become weaker. Treatment for your injury may also undermine respiratory health, or make it difficult to breathe on your own.