New Device Helps Spinal Cord Injury Patients Regain Independence
Jeffery Johnson, 43, has relied on a ventilator to help him breathe since 2007 when he fell two stories while siding a house, resulting in a severe spinal cord injury that paralyzed his respiratory muscles. On February 2, Johnson received a diaphragm pacing system, the first implanted in Illinois, that will help him breathe more naturally, restore his speech patterns, and regain his senses of taste and smell.
The pacing system works by electrically stimulating the muscle and nerves in the diaphragm to imitate natural breathing. During surgery, a neurostimulation device is implanted on the diaphragm, which when stimulated contracts to create a vacuum-like effect in the chest that allows air to fill the upper and lower parts of the lungs. When the contraction eases, the air is expelled from the lungs, mimicking natural breathing. Surgeons at Northwestern Memorial Hospital, one of only 18 centers in the U.S. offering the procedure, implanted the system in Johnson during a minimally invasive surgical procedure.
“The diaphragm pacing system sets a new standard of care for the 12,000 people in the United States with severe spinal cord injuries who can’t breathe on their own,” said Eric Hungness, MD, the minimally invasive surgeon at Northwestern Memorial who, along with Alberto de Hoyos, MD, thoracic surgeon at Northwestern Memorial, performed the operation. “It's a tremendous step forward in helping patients improve their quality of life and independence.”
Following surgery, patients undergo continued care at the Rehabilitation Institute of Chicago (RIC) to strengthen their diaphragms and learn how the pacing system works. Patients with severe spinal cord injuries have weakened diaphragms, which make it difficult for them to use the pacing system for long amounts of time right after surgery, according to Lisa Wolfe, MD, a pulmonary rehabilitation specialist at Northwestern Memorial. “During rehabilitation, as their diaphragms become conditioned and stronger, patients spend less time on the ventilator and more time breathing on their own,” adds Wolfe.
Only two days after his surgery, Johnson was pacing for 30 minutes, several times a day. He continues to work with rehabilitation experts to condition his diaphragm and will spend increasing time off the ventilator as he becomes stronger.
In clinical trials of the pacing system, approximately 50 percent of patients achieved full-time pacing and were able to completely eliminate their positive pressure ventilation units. Additionally, about 60 percent of patients in the trial were able to use the pacing system more than 12 hours per day.
Today, Johnson is pacing for 10 hours each day and is able to talk again. He is particularly excited about regaining his sense of smell and taste, and would like to plan a trip to visit his brother in Austria. “I hope that this procedure will give me more freedom in my life,” he said.