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

• Published in: The journal of spinal cord medicine 2022-05, Vol.45 (3), p.354-363
• Main Authors: DiMarco, Anthony F., Geertman, Robert T., Nemunaitis, Gregory A., Kowalski, Krzysztof E.
• Format: Article
• Language: English
• Subjects: Cough; Cough - therapy; Electrodes, Implanted; Humans; Rehabilitation; Respiratory muscles; Respiratory Muscles - physiology; Spinal Cord; Spinal Cord Injuries - complications; Spinal cord injury; Spinal Cord Stimulation - adverse effects; Spinal Cord Stimulation - methods; Tetraplegia
• ISSN: 1079-0268; 2045-7723
• DOI: 10.1080/10790268.2021.1936388

To compare the safety and effectiveness of wire (WE) vs. disc (DE) electrodes to restore cough in subjects with spinal cord injury (SCI). Clinical trials assessing the effectiveness and clinical outcomes associated with two electrode systems to activate the expiratory muscles. Inpatient hospital setting for DE or WE electrode insertion; outpatient evaluation of cough efficacy and instructions for home use. Twenty-nine subjects with SCI; 17 participants with DE and 12 with WE implants. Surgical implantation of WE or DE to restore cough. Daily application of spinal cord stimulation (SCS) at home. Airway pressure (P) and peak airflow (F) generation achieved with SCS; clinical parameters including ease in raising secretions, incidence of acute respiratory tract infections (RTI) and side effects. P and F achieved with DE and WE were not significantly different. For example, at total lung capacity (TLC) with participant effort, P was 128 ± 12 cmH 2 O and 118 ± 14 cmH 2 O, with DE and WE, respectively. The degree of difficulty in raising secretions improved markedly in both groups. The incidence of RTI per year fell from 1.3 ± 0.3 and 1.3 ± 0.5-0.3 ± 0.1 and 0.1 ± 0.1 for DE and WE groups, respectively (P