Phrenic Nerve Stimulation for Diaphragmatic Pacing in a Patient with High Cervical Spinal Cord Injury(cid:31)
Bunpot Sitthinamsuwan MD, MSc*, Sarun Nunta-aree MD, PhD*
Affiliation : (cid:31) Presented in Annual Scientific Meeting of the Neurosurgical Association of Thailand (NAT) 2008 and The First Annual Scientific Meeting of The College of Neurosurgeon of Thailand: Advance in Neuro-Oncology, Chiang Mai, Thailand: 21-23 February 2008 * Division of Neurosurgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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 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.
Conclusion : Phrenic nerve stimulation for diaphragmatic pacing can reduce all-time requirement of
ventilatory support in patients with high cervical spinal cord injury.
Keywords : Central hypoventilation syndrome, Phrenic nerve stimulation
