Journal
ASIAN SPINE JOURNAL
Volume 15, Issue 6, Pages 874-880Publisher
KOREAN SOC SPINE SURGERY
DOI: 10.31616/asj.2020.0227
Keywords
Phrenic nerve stimulation with diaphragm pacing; Traumatic tetraplegia; Ventilator dependence; Spinal cord injury rehabilitation
Categories
Funding
- Department of Rehabilitation, Spinal Cord Injury Centre, Military Hospital Kirkee, Pune, India
Ask authors/readers for more resources
Challenges in rehabilitation for tetraplegics with high cervical spinal cord injuries include respiratory failure and chronic ventilator dependence, but diaphragm pacing with phrenic nerve stimulation may offer a way for these patients to wean off mechanical ventilation, achieve spontaneous breathing, and undergo rehabilitation.
Respiratory failure and chronic ventilator dependence in tetraplegics following cervical injuries located high on the spine (C1-C3) constitute significant challenges in the rehabilitation of patients given the occurrence of repeated hospitalizations and an ever-increasing financial burden. A 30-year-old man presented with posttraumatic tetraplegia following an unstable injury at the C1-C2 level with cord compression; he was managed by posterior stabilization and decompression followed by ventilator dependence and no rehabilitation until 6 months postinjury. We implanted phrenic nerve stimulator electrodes bilaterally for indirect diaphragm pacing by an implantable pulse generator that allowed for weaning from mechanical ventilation and spontaneous ventilator-free breathing at 20 weeks post-implantation and which facilitated post-tetraplegia rehabilitation. At 36 months after implantation, the patient is ventilator-free without any procedure-related complications or respiratory infections. Diaphragm pacing with phrenic nerve stimulation may be a way forward for ventilator-dependent tetraplegics in developing countries to pursue effective rehabilitation and improved quality of life.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available