Phrenic Nerve Stimulator Placement via the Cervical Approach: Technique and Anatomic Considerations

BACKGROUND: Diaphragmatic pacing via phrenic nerve stimulation can help improve breathing and facilitate mechanical ventilation weaning in patients with respiratory failure secondary to brainstem injury, high cervical spinal cord injury, or congenital central hypoventilation. Devices can be placed utilizing several techniques; however, nuances regarding placement are not well published. OBJECTIVE: To describe our experience with phrenic nerve stimulator placement via the cervical approach with a focus on surgical anatomy, variations, and technique. METHODS: Placement of phrenic nerve stimulator via a cervical approach is described in detail. RESULTS: Successful placement of phrenic nerve stimulator without complication. CONCLUSION: The cervical approach for the placement of a phrenic nerve stimulator is a safe and effective option for patients. Detailed knowledge of anatomy and anatomic variations is required. Potential advantages and disadvantages are discussed.