Phrenic nerve stimulation for diaphragmatic pacing in a patient with high cervical spinal cord injury.
BACKGROUND
Phrenic nerve stimulation is a therapeutic option for patients with central hypoventilation syndrome due to brain stem and high cervical spinal cord dysfunction.


METHODS
A 28-year-old woman with high cervical spinal cord injury at the level of C2 had chronic central hypoventilation syndrome, requiring long-term use of a home ventilator Preoperative end tidal CO2 and tidal volume during spontaneous breathing indicated hypoventilation syndrome. Bilateral phrenic nerve stimulation for diaphragmatic pacing was performed with spinal cord stimulators used for chronic pain. The end tidal CO2 pressure (ETCO2), tidal volume, and spontaneous breathing time have improved up to 29 months of postoperative follow-up period.


CONCLUSIONS
Phrenic nerve stimulation for diaphragmatic pacing can reduce all-time requirement of ventilatory support in patients with high cervical spinal cord injury.
Sitthinamsuwan
Bunpot
B
Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. bunpotsi@yahoo.com
Nunta-aree
Sarun
S
D000328:Adult; D001368:Axis, Cervical Vertebra / Q000293:injuries; D002574:Cervical Vertebrae; D003964:Diaphragm / Q000294:innervation* / Q000502:physiology; D004599:Electric Stimulation Therapy; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data; D006801:Humans; D007040:Hypoventilation / Q000209:etiology / Q000628:therapy*; D010791:Phrenic Nerve / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000150:complications / Q000628:therapy*; D016103:Spinal Fractures / Q000150:complications; D013577:Syndrome; D012122:Ventilators, Mechanical / Q000706:statistics & numerical data