In 1996, Keith, an 18-year old diving and gymnastic enthusiast, suffered an accident on a trampoline which rendered him quadriplegic and ventilator dependent.
Preoperative EMGs indicated that his phrenic nerve function was lost, although these tests have a high degree of false negative readings. Direct stimulation performed intraoperatively confirmed the absence of phrenic nerve conduction, and intercostal nerve grafts were performed. Customized stimulus parameters for Keith’s external transmitter were established by our personnel using a computer-assisted optimization technique.
Keith has now been pacing for over ten years, and currently uses his pacers 24 hours per day with tidal volumes in excess of 500 cc’s. “It feels like I’m breathing on my own…just like I used to” he says. Keith is currently studying health and human development and after graduation hopes to work as a counselor.
Quadriplegia, also known as tetrapalegia, is the loss of voluntary movement and sensation in all four extremities, and usually results from a cervical spinal cord injury (SCI). Other conditions, such as a brain stem lesion or spinal meningitis, may also result in quadriplegia. After the patient is neurologically and orthopedically stable and cannot be weaned from mechanical ventilation, a diaphragm pacing system should be considered.