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    The content on this page is not current guidance and is only for the purposes of the consultation process.

    Indications and current treatment

    A high cervical SCI is an injury in the upper neck between the first and fourth cervical vertebrae (C1 to C4). SCIs can damage the PN that controls the diaphragm (the main muscle used in breathing) and cause chronic respiratory insufficiency. Some people with high cervical SCIs cannot breathe on their own, so they need a mechanical ventilator to help them breathe.

    Standard care for managing respiratory insufficiency caused by SCIs includes non-invasive ventilation (such as bi-level positive airway pressure) and invasive MV (such as intubation or tracheostomy). An alternative to ventilatory support is intramuscular diaphragm stimulation for people with intact PN function.