Diaphragm pacing implantation in Japan for a patient with cervical spinal cord injury: A case report

Medicine, 2022 · DOI: http://dx.doi.org/10.1097/MD.0000000000029719 · Published: June 24, 2022

Spinal Cord Injury Pulmonology Rehabilitation

Simple Explanation

This case report describes a 24-year-old man with a cervical spinal cord injury who required mechanical ventilation. After 1.5 years, a diaphragmatic pacing stimulator was implanted to support his breathing. The patient was successfully weaned off the ventilator 14 weeks after implantation and returned to daily life without mechanical support. This report suggests that diaphragmatic pacing implantation is a promising treatment for improving respiratory function after severe cervical spinal cord injury.

Study Duration

2 years

Participants

1 patient with cervical spinal cord injury

Evidence Level

Level 4: Case Report

Key Findings

1
Diaphragm pacing implantation significantly improved respiratory function after cervical SCI.
2
Diaphragmatic pacing promoted lung capacity and tidal volume, allowing the patient to be weaned from the ventilator.
3
The patient was successfully withdrawn from mechanical ventilation 14 weeks post-implantation, and the tracheostomy was closed 19 weeks post-implantation. The patient was not reintubated during the 2-year follow-up period.

Research Summary

This case report presents the successful use of diaphragm pacing implantation in a patient with cervical SCI, leading to improved respiratory function and ventilator weaning. The study highlights the potential of diaphragm pacing as a treatment option for respiratory dysfunction caused by severe SCI. The findings suggest that diaphragm pacing can improve activities of daily living in patients with respiratory failure following cervical SCI.

Practical Implications

Clinical Practice

Diaphragm pacing implantation can be considered as a treatment option for improving respiratory function in patients with cervical SCI and respiratory failure.

Future Research

Further clinical studies are needed to confirm the efficacy of diaphragm pacing in a larger patient population and to optimize the stimulation parameters.

Healthcare Policy

The successful outcome of this case may support the expansion of insurance coverage for diaphragm pacing implantation in SCI patients in Japan.

Study Limitations

1
Single case report limits generalizability.
2
Conditioning criteria for diaphragmatic stimulation are not yet well established.
3
Electrodes are connected to the pulse generator outside the body, which could lead to wound infection.

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