Spinal Cord Injury (SCI)

Spinal Cord Injury and the Avery Diaphragm Pacemaker

The Avery Diaphragm Pacemaker is a reliable solution for adult and pediatric patients who are chronically dependent on mechanical ventilation due to:

  • Spinal cord injuries, especially high cervical (C1–C3) level injuries
  • Cervical spine trauma
  • Brainstem lesions
  • Strokes affecting respiratory control centers

By stimulating the phrenic nerve, the Avery device enables more natural breathing for up to 24 hours a day.

Life-Changing Benefits

  • Fewer Hospital Readmissions
    Patients often experience fewer setbacks and hospital stays by avoiding common ventilator-related complications like VAP (ventilator-associated pneumonia) and VIDD (ventilator-induced diaphragm dysfunction).
  • Lower Risk of Infections
    With less need for suctioning, no external ventilator tubing, and in some cases, removal of the tracheostomy, the risk of infection is significantly reduced.
  • Improved Circulatory Return
    Negative-pressure breathing supports healthier circulation and helps the lungs function more efficiently than positive-pressure ventilation (PPV).
  • Proven Clinical Success
    Studies have found quadriplegic patients maintained normal tidal volumes and arterial blood gases while pacing (Including 2002 study: Elefteriades et al., 2002).
  • Natural Breathing and Speech Patterns
    With the Avery Diaphragm Pacemaker, users experience ease of eating, drinking, and speaking.
  • Discreet Design, Silent Operation
    The Avery device is small, quiet, and portable. Many patients can live at home, reducing or eliminating the need for bulky ventilators and disposable supplies — significantly lowering long-term care costs.

Who is a Candidate for the Diaphragm Pacing System?

The Avery Diaphragm Pacing System is indicated for persons who require chronic ventilatory support because of upper motor neuron respiratory muscle paralysis (RMP) or because of central alveolar hypoventilation (CAH) and whose remaining phrenic nerve, lung and diaphragm function whose sufficient to accommodate electrical stimulation.

Candidates for Diaphragm Pacing include, but are not limited to those with:

  • Spinal Cord Injury or disease
  • Central Alveolar Hypoventilation
  • Decreased day or night ventilatory drive (i.e. Sleep Apnea, Ondine’s Syndrome)
  • Brain stem injury or disease
  • Other forms of diaphragm paralysis
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Brodie, Pacing Since 1980.

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Spinal Cord Injury And The Need For Ventilatory Assistance

Tetraplegia 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 Tetraplegia which is also known as Quadriplegia.

An SCI can be complete or incomplete. The term incomplete indicates that the patient has some sensory or motor function below the injury level. There are seven cervical vertebrae and eight cervical nerves, identified as C1 through C8. The level of injury directly correlates to the patients abilities and needs.

The phrenic nerve originates at C3 through C5 and is the neurological pathway between the brain and the diaphragm. Injuries that occur at or above C4 can interrupt these pathways and render the patient ventilatory dependent. After the patient is neurologically and orthopedically stable and cannot be weaned from mechanical ventilation, an Avery Diaphragm Pacing System should be considered.

• Patients with an injury or disease at C1, C2, and higher may have little or no movement of their head and neck, and may be entirely dependent on ventilatory assistance for breathing.
Spinal Cord Injury― 1. ―
• Patients with an injury at C3 usually have control of their head and neck and are occasionally weaned from ventilatory assistance.
Spinal Cord Injury― 2. ―
• Patients with an injury at C4 usually have control of their head and neck, some shoulder movement and are often weaned from ventilatory assistance.
Spinal Cord Injury― 3. ―
• Patients with injuries at C5 and lower have control of their head and neck, progressively more control of their arms and hands and are rarely in need of ventilatory assistance.
Spinal Cord Injury― 4. ―
• Patients with injuries below the cervical spine have full function in the upper extremities, which is classified as paraplegia. Paraplegics do not lose control of respiratory drive.
Spinal Cord Injury― 5. ―

The Avery Diaphragm Pacemaker (phrenic nerve stimulator) is indicated for adult and pediatric patients who require chronic ventilatory support because of upper motor neuron respiratory muscle paralysis (RMP) or because of central alveolar hypoventilation (CAH) and whose remaining phrenic nerve, lung and diaphragm functions is sufficient to accommodate electrical stimulation.

The Avery Diaphragm Pacing System has full FDA PMA approval (FDA PMA P860026) and is covered by Medicare and most private and government insurances.