Thirty-Six-Month Follow-up of Diaphragm Pacing with Phrenic Nerve Stimulation for Ventilator Dependence in Traumatic Tetraplegia: The Way Forward for Spinal Cord Injury Rehabilitation in a Developing Country
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...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2021-12-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2020-0227.pdf |
| _version_ | 1819320200149860352 |
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| author | Vyom Sharma Haris Jafri Nilanjan Roy Manish Dangi Mohit Kataruka |
| author_facet | Vyom Sharma Haris Jafri Nilanjan Roy Manish Dangi Mohit Kataruka |
| author_sort | Vyom Sharma |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-24T11:15:48Z |
| format | Article |
| id | doaj.art-8db6066e93c74f54a0727423c0b2ff0e |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-24T11:15:48Z |
| publishDate | 2021-12-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-8db6066e93c74f54a0727423c0b2ff0e2022-12-21T16:58:23ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462021-12-0115687488010.31616/asj.2020.02271315Thirty-Six-Month Follow-up of Diaphragm Pacing with Phrenic Nerve Stimulation for Ventilator Dependence in Traumatic Tetraplegia: The Way Forward for Spinal Cord Injury Rehabilitation in a Developing CountryVyom Sharma0Haris Jafri1Nilanjan Roy2Manish Dangi3Mohit Kataruka4 Department of Orthopaedics and Spine Surgery, Spinal Cord Injury Centre, Military Hospital Kirkee, Pune, India Department of Surgery, Armed Forces Medical College, Pune, India Department of Surgery, Armed Forces Medical College, Pune, India Department of Anaesthesiology and Critical Care, Indian Naval Hospital Ship Kalyani, Visakhapatnam, India Department of Orthopaedics and Spine Surgery, Spinal Cord Injury Centre, Military Hospital Kirkee, Pune, IndiaRespiratory 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.http://www.asianspinejournal.org/upload/pdf/asj-2020-0227.pdfphrenic nerve stimulation with diaphragm pacingtraumatic tetraplegiaventilator dependencespinal cord injury rehabilitation |
| spellingShingle | Vyom Sharma Haris Jafri Nilanjan Roy Manish Dangi Mohit Kataruka Thirty-Six-Month Follow-up of Diaphragm Pacing with Phrenic Nerve Stimulation for Ventilator Dependence in Traumatic Tetraplegia: The Way Forward for Spinal Cord Injury Rehabilitation in a Developing Country Asian Spine Journal phrenic nerve stimulation with diaphragm pacing traumatic tetraplegia ventilator dependence spinal cord injury rehabilitation |
| title | Thirty-Six-Month Follow-up of Diaphragm Pacing with Phrenic Nerve Stimulation for Ventilator Dependence in Traumatic Tetraplegia: The Way Forward for Spinal Cord Injury Rehabilitation in a Developing Country |
| title_full | Thirty-Six-Month Follow-up of Diaphragm Pacing with Phrenic Nerve Stimulation for Ventilator Dependence in Traumatic Tetraplegia: The Way Forward for Spinal Cord Injury Rehabilitation in a Developing Country |
| title_fullStr | Thirty-Six-Month Follow-up of Diaphragm Pacing with Phrenic Nerve Stimulation for Ventilator Dependence in Traumatic Tetraplegia: The Way Forward for Spinal Cord Injury Rehabilitation in a Developing Country |
| title_full_unstemmed | Thirty-Six-Month Follow-up of Diaphragm Pacing with Phrenic Nerve Stimulation for Ventilator Dependence in Traumatic Tetraplegia: The Way Forward for Spinal Cord Injury Rehabilitation in a Developing Country |
| title_short | Thirty-Six-Month Follow-up of Diaphragm Pacing with Phrenic Nerve Stimulation for Ventilator Dependence in Traumatic Tetraplegia: The Way Forward for Spinal Cord Injury Rehabilitation in a Developing Country |
| title_sort | thirty six month follow up of diaphragm pacing with phrenic nerve stimulation for ventilator dependence in traumatic tetraplegia the way forward for spinal cord injury rehabilitation in a developing country |
| topic | phrenic nerve stimulation with diaphragm pacing traumatic tetraplegia ventilator dependence spinal cord injury rehabilitation |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2020-0227.pdf |
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