Article

A prospective study. OBJECTIVES: To evaluate the effect of the
surgery to reconstruct thoracic breathing in patients with high cervical spinal
cord injury (CSCI). SETTING: China Rehabilitation Research Center, Beijing,
China. METHODS: The posterior ribs (from the fifth to the eighth) were suspended
on the inferior angle of the scapula on each side using titanium cables, as well
as muscles and myofascial tissue in the subscapular area. After the surgery, the
patients were trained for synchronous contraction of the trapezius and diaphragm
muscles, and electromyography (EMG) was performed to evaluate the
synchronization. The clinical symptoms and pulmonary function were assessed
within 1 week before surgery and at 2, 12 and 24 postoperative weeks. RESULTS:
Six patients with complete high CSCI received rib suspension surgery 84+/-26.7
days after spinal cord injury. Before the surgery, all of the patients presented
with weakened cough, retention of respiratory secretions and dyspnea, while these
symptoms alleviated postoperatively. The vital capacity (VC) was enhanced to be
1680+/-282 ml at 2 weeks after the surgery, compared with 1085+/-92 ml (P=0.013).
The EMG showed a synchronous muscle electrical activity between the trapezius
muscles and diaphragm during deep breaths. CONCLUSION: The rib suspension surgery
partially restored the thoracic breathing of the patients with high CSCI, thereby
improving VC, cough and expectoration.

Langue : ANGLAIS