Neuromodulation on Cervical Spinal Cord Combined With Hyperbaric Oxygen in Comatose Patients--A Preliminary Report

Surg Neurol. 2009 Dec;72 Suppl 2:S28-34; discussion S34-5. doi: 10.1016/j.surneu.2009.05.029. Epub 2009 Aug 7.

Abstract

Background: Because both SCS and HBO therapy have shown some promise in treating patients with states of reduced consciousness, we evaluated the combination of therapies in a prospective trial in comatose patients.

Methods: Twelve patients who had received median nerve stimulation for 3 months without improvement in consciousness received cSCS for 1 year combined with simultaneous HBO therapy for the first 3 months. Another group enrolled 12 patients who received median nerve stimulation only were served as control.

Results: Six patients emerged from coma at 1 year (after conclusion of treatment). Glasgow Coma Scale score, SPECT imaging, and PVS scores (state and reaction subscores) of the 12 patients were all significantly increased at 1 year compared with enrollment (P < .05). Neither respirator nor tracheostomy was needed to assist respiration in any patient. Only 1 of 12 patients still needed nasogastric tube feeding at 1 year. By contrast, control patients (without cSCS and HBO therapy) showed no apparent improvement.

Conclusion: Increase of GCS score, cerebral blood perfusion, and PVS scores were observed in comatose patients treated with combined cSCS and HBO therapy.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers
  • Brain Hemorrhage, Traumatic / complications
  • Brain Hemorrhage, Traumatic / physiopathology
  • Cerebrovascular Circulation / physiology
  • Cervical Vertebrae / surgery
  • Coma / diagnostic imaging
  • Coma / physiopathology
  • Coma / therapy*
  • Combined Modality Therapy / instrumentation
  • Combined Modality Therapy / methods
  • Electric Stimulation Therapy / methods*
  • Electric Stimulation Therapy / statistics & numerical data
  • Electrodes, Implanted
  • Enteral Nutrition / statistics & numerical data
  • Female
  • Glasgow Coma Scale
  • Humans
  • Hyperbaric Oxygenation / methods*
  • Hyperbaric Oxygenation / statistics & numerical data
  • Male
  • Median Nerve / physiology
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Respiration, Artificial / statistics & numerical data
  • Spinal Cord / physiology
  • Spinal Cord / surgery*
  • Tomography, Emission-Computed, Single-Photon
  • Treatment Outcome
  • Young Adult

Substances

  • Biomarkers