Phrenic nerve stimulation in complex rehabilitation for cervical spinal cord injury using modified implantable device (case report)

Background Cervical spinal cord injury (CSCI) can result in numerous pulmonary complications and special attention to respiratory support is vital in rehabilitation of the patients. Aim To develop regimens for an implantable generator of electrical impulses to be used in phrenic nerve stimulation to liberate or wean a patient from mechanical ventilator. Material and methods Stimulation of the phrenic nerve was performed for a 9-year-old boy with a traumatic spinal cord injury and complete anatomical disruption of the spinal cord at the C2 vertebra level. Artificial and auxiliary lung ventilation was provided for the patient with the CareFusion LTV 1200 system (USA). Nerve monitor ISIS IOM (Inomed Medizintechnik GmbH, Germany) was used to control the phrenic nerve. Statistical analysis of baseline data was produced with two-tailed Student's t-test. Microsoft Excel and AtteStat program, version 13.1 were used to complete data analysis reports. Results A four-contact cylindrical electrode was inserted into the epidural space of the cervical vertebrae and placed at cervical levels C2-C4 with a minimally invasive procedure and a course of electrical stimulation was initiated...