Comparison of disc and wire electrodes to restore cough via lower thoracic spinal cord stimulation

The Journal of Spinal Cord Medicine, 2022 · DOI: 10.1080/10790268.2021.1936388 · Published: January 1, 2022

Spinal Cord Injury Pulmonology Neurology

Simple Explanation

Individuals with cervical and high thoracic spinal cord injury (SCI) often have an ineffective cough due to paralysis of expiratory muscles. Lower thoracic spinal cord stimulation (SCS) can activate expiratory muscles and restore an effective cough. This study compares disc electrodes (DE) and wire electrodes (WE) for restoring cough in SCI subjects, finding similar effectiveness and benefits.

Study Duration

Not specified

Participants

29 subjects with SCI; 17 with DE and 12 with WE implants

Evidence Level

Clinical trials

Key Findings

1
Airway pressure (P) and peak airflow (F) achieved with disc electrodes (DE) and wire electrodes (WE) were not significantly different.
2
Both DE and WE significantly improved the ease of raising secretions and reduced the incidence of respiratory tract infections.
3
The only significant side effect, short-term autonomic dysreflexia, was similar between the DE and WE groups.

Research Summary

This study compared disc (DE) and wire (WE) electrodes for restoring cough via lower thoracic spinal cord stimulation (SCS) in SCI subjects. Results showed no significant differences in expiratory muscle activation, clinical benefits, or side effects between DE and WE. The study suggests that WE, which can be placed using minimally invasive techniques, are as effective as DE with the added benefits of lower cost, surgical time, and overall risk.

Practical Implications

Minimally Invasive Cough Restoration

Wire electrodes offer a less invasive and more cost-effective method for restoring cough function in individuals with SCI.

Comparable Effectiveness

Clinicians can choose either disc or wire electrodes based on surgical preference and patient needs, knowing both are equally effective.

Improved Respiratory Health

Spinal cord stimulation, using either electrode type, can significantly reduce respiratory complications and improve the quality of life for SCI patients.

Study Limitations

1
The total number of individuals evaluated while significant is still somewhat small.
2
Ideally, clinical studies should include a matched control group.
3
Since blinding could not be practically implemented due to the marked muscle contraction resulting from SCS, randomization was not part of the study design.

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