Interventional procedure overview of phrenic nerve pacing for ventilator-dependent high cervical spinal cord injury
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Existing assessments of this procedure
In April 2023, the NHS Commissioning Board (CB) published the clinical commissioning policy on PNP following SCI (NHS Commissioning Coard Clinical Reference Group, 2023). The NHS CB states that the specialist nature of this intervention and the fact that only 1 UK centre has published outcome data imply that, should it be commissioned, this procedure may only be suitable for provision in designated centres with special arrangements for clinical governance, consent, and audit or research.
The NHS Commissioning Board will commission PNP following SCI in accordance with the criteria for selecting people with chronic ventilator-dependent traumatic or non-traumatic SCIs:
Who have been offered the opportunity to discuss the clinical and psychological impact of the 2 possible outcomes of assessment and their responses to receiving a positive or negative screening outcome. This should be undertaken by suitable trained consultants in SCI and respiratory management after SCI, and a SCI clinical psychologist.
Who have an intact functioning PN, as confirmed by electromyographic response of the diaphragm to nerve stimulation.
Who have discussed with the implanting consultant the known risks and benefits associated with surgery and implantation and given their consent for surgery.
Who are under the care of the commissioned implanting centre.
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