Thoracoscopic intercostal to phrenic nerve transposition for diaphragmatic reanimation in the quadriplegic child.

Objective: To describe for the first time a novel technique of thoracoscopic intercostal nerve mobilization and intercostal to phrenic nerve transposition in the setting of quadriplegia with the goal of reanimating the diaphragm and decreasing ventilator dependence. Description: A 5 year old female on 24 hour ventilator support secondary to traumatic quadriplegia was evaluated for possible phrenic nerve pacing. In clinic, bilateral cervical phrenic nerves were stimulated with electromyography while ultrasound was used to monitor contractions of the diaphragm. Right sided stimulation resulted in …