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

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.