Phrenic nerve stimulation for diaphragmatic pacing in a patient with high cervical spinal cord injury

Abstract

Background: Phrenic nerve stimulation is a therapeutic option for patients with central hypoventilation syndrome due to brain stem and high cervical spinal cord dysfunction. Case Report: 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 CO 2 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. Conclusion: Phrenic nerve stimulation for diaphragmatic pacing can reduce all-time requirement of ventilatory support in patients with high cervical spinal cord injury.