Background: Spinal cord injury (SCI) results in significant loss in pulmonary function secondary to respiratory muscle paralysis. Retention of secretions and atelectasis and, recurrent respiratory tract infections may also impact pulmonary function.

Objective: To determine whether usage of lower thoracic spinal cord stimulation (SCS) to restore cough may improve spontaneous pulmonary function in individuals with chronic SCI.

Design/Methods: 10 tetraplegics utilized SCS system on a regular daily basis. Spontaneous inspiratory capacity (IC), maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) were measured at baseline prior to usage of the device and repeated every 4–5 weeks over a 20-week period. Maximum airway pressure generation (P) during SCS (40 V, 50 Hz, 0.2 ms) at total lung capacity (TLC) with subject maximal expiratory effort, at the same timepoints were determined, as well.

Results: Following daily use of SCS, mean IC improved from 1636 ± 229 to 1932 ± 239 ml (127 ± 8% of baseline values) after 20 weeks (P < 0.05). Mean MIP increased from 40 ± 7, to 50 ± 8 cmH₂O (127 ± 6% of baseline values) after 20 weeks, respectively (P < 0.05). MEP also improved from 27 ± 3.7 to 33 ± 5 (127 ± 14% of baseline values) (NS). During SCS, P increased from baseline in all participants from mean 87 ± 8 cmH₂O to 117 ± 14 cmH₂O at weeks 20, during TLC with subject maximal expiratory effort, respectively (P < 0.05). Each subject stated that they experienced much greater ease in raising secretions with use of SCS.

Conclusion: Our findings indicate that use of SCS not only improves expiratory muscle function to restore cough but also results in improvement inspiratory function, as well.

背景：脊髓损伤（SCI）导致继发呼吸肌麻痹的肺功能显着丧失。分泌物潴留、肺不张以及反复呼吸道感染也可能影响肺功能。

目的：确定使用下胸段脊髓刺激 (SCS) 恢复咳嗽是否可以改善慢性 SCI 患者的自发肺功能。

设计/方法： 10 名四肢瘫痪患者每天定期使用 SCS 系统。在使用该设备之前，在基线处测量自主吸气量 (IC)、最大吸气压力 (MIP) 和最大呼气压力 (MEP)，并在 20 周内每 4-5 周重复测量一次。还确定了在 SCS（40 V，50 Hz，0.2 ms）期间在总肺活量（TLC）和受试者最大呼气力下的最大气道压力生成（P），同时也在同一时间点进行了确定。

结果：每天使用 SCS 后，20 周后平均 IC 从 1636 ± 229 改善至 1932 ± 239 ml（基线值的 127 ± 8%）（P < 0.05）。20 周后，平均 MIP 分别从 40 ± 7 增加至 50 ± 8 cmH ₂ O（基线值的 127 ± 6%）（P < 0.05）。MEP 也从 27 ± 3.7 提高到 33 ± 5（基线值的 127 ± 14%）（NS）。在 SCS 期间，所有参与者的 P 值均从基线增加，从平均 87 ± 8 cmH ₂ O 增加到第 20 周时的 117 ± 14 cmH ₂ O（在 TLC 期间，受试者最大呼气用力）（P < 0.05）。每个受试者都表示，使用 SCS 后，他们在分泌物分泌方面感到更加轻松。

结论：我们的研究结果表明，使用 SCS 不仅可以改善呼气肌功能以恢复咳嗽，而且还可以改善吸气功能。