title: A preliminary evaluation of the surgery to reconstruct thoracic breathing in patients with high cervical spinal cord injury.
abstract: METHODS
  A prospective study.
  
  
  OBJECTIVE
  To evaluate the effect of the surgery to reconstruct thoracic breathing in patients with high cervical spinal cord injury (CSCI).
  
  
  METHODS
  China Rehabilitation Research Center, Beijing, China.
  
  
  METHODS
  The posterior ribs (from the fifth to the eighth) were suspended on the inferior angle of the scapula on each side using titanium cables, as well as muscles and myofascial tissue in the subscapular area. After the surgery, the patients were trained for synchronous contraction of the trapezius and diaphragm muscles, and electromyography (EMG) was performed to evaluate the synchronization. The clinical symptoms and pulmonary function were assessed within 1 week before surgery and at 2, 12 and 24 postoperative weeks.
  
  
  RESULTS
  Six patients with complete high CSCI received rib suspension surgery 84±26.7 days after spinal cord injury. Before the surgery, all of the patients presented with weakened cough, retention of respiratory secretions and dyspnea, while these symptoms alleviated postoperatively. The vital capacity (VC) was enhanced to be 1680±282 ml at 2 weeks after the surgery, compared with 1085±92 ml (P=0.013). The EMG showed a synchronous muscle electrical activity between the trapezius muscles and diaphragm during deep breaths.
  
  
  CONCLUSIONS
  The rib suspension surgery partially restored the thoracic breathing of the patients with high CSCI, thereby improving VC, cough and expectoration.
authors.affiliation: 1] Capital Medical University School of Rehabilitation Medicine, Beijing, China [2] Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China [3] Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China.
authors.forename: M L
authors.initials: ML
authors.lastname: Yang
authors.affiliation: 1] Capital Medical University School of Rehabilitation Medicine, Beijing, China [2] Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China [3] Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China.
authors.forename: J J
authors.initials: JJ
authors.lastname: Li
authors.affiliation: 1] Capital Medical University School of Rehabilitation Medicine, Beijing, China [2] Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China.
authors.forename: F
authors.initials: F
authors.lastname: Gao
authors.affiliation: 1] Capital Medical University School of Rehabilitation Medicine, Beijing, China [2] Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China.
authors.forename: L J
authors.initials: LJ
authors.lastname: Du
authors.affiliation: Capital Medical University School of Rehabilitation Medicine, Beijing, China.
authors.forename: H P
authors.initials: HP
authors.lastname: Zhao
authors.affiliation: 1] Capital Medical University School of Rehabilitation Medicine, Beijing, China [2] Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China.
authors.forename: Y M
authors.initials: YM
authors.lastname: Wang
authors.affiliation: 1] Capital Medical University School of Rehabilitation Medicine, Beijing, China [2] Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China.
authors.forename: D G
authors.initials: DG
authors.lastname: Yang
authors.affiliation: 1] Capital Medical University School of Rehabilitation Medicine, Beijing, China [2] Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China.
authors.forename: L
authors.initials: L
authors.lastname: Chen
authors.affiliation: 1] Capital Medical University School of Rehabilitation Medicine, Beijing, China [2] Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China.
authors.forename: H W
authors.initials: HW
authors.lastname: Liu
authors.affiliation: 1] Capital Medical University School of Rehabilitation Medicine, Beijing, China [2] Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China.
authors.forename: H D
authors.initials: HD
authors.lastname: Yang
authors.affiliation: 1] Capital Medical University School of Rehabilitation Medicine, Beijing, China [2] Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China.
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.affiliation: 1] Capital Medical University School of Rehabilitation Medicine, Beijing, China [2] Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China.
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.affiliation: 1] Capital Medical University School of Rehabilitation Medicine, Beijing, China [2] Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China.
authors.forename: H M
authors.initials: HM
authors.lastname: Gong
authors.affiliation: 1] Capital Medical University School of Rehabilitation Medicine, Beijing, China [2] Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China.
authors.forename: T J
authors.initials: TJ
authors.lastname: Zhou
mesh_terms: D000009:Abdominal Muscles / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D066193:Cervical Cord / Q000293:injuries*; D003371:Cough; D003964:Diaphragm / Q000503:physiopathology; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D019637:Orthopedic Procedures / Q000009:adverse effects; D012119:Respiration; D012120:Respiration Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D012129:Respiratory Function Tests; D012272:Ribs / Q000601:surgery*; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity