• Okuma I, Hayashi J, Kaito T, Funahashi M, Kuno S, Kato Y, Shoda M, Nagata J, Keith MW and Kanno T (2003). Functional electrical stimulation (FES) for spinal cord injury. Acta Neurochir Suppl 87:53-5. Summary: Restoration of respiratory motion by stimulation of the phrenic nerve was investigated. Respiratory motion was restored successfully by introducing a breathing pacemaker to a patient with respiratory disturbance due to upper cervical spinal cord injury. Breathing pacemakers are considered to be more similar to physiological conditions compared to mechanical ventilators. Although the system is very expensive, its cost effectiveness may be excellent, provided that it can be used for long hours each day over an extended period. The system is effective in improving patient QOL because it dramatically increases patient mobility. From these findings, it is concluded that breathing pacemakers should be used more frequently in Japan, and that various forms of support are necessary to cope with economic and other concerns. Department of Neurosurgery, Fujita Health University, Toyoake, Aichi, Japan. neuron@fujita-hu.ac.jp