Phrenic Nerve Surgery and
Phrenic Nerve Program

The phrenic nerve controls function of the diaphragm muscle, the primary muscle involved in breathing. When this nerve becomes damaged, phrenic nerve reconstruction may be performed to reverse diaphragm paralysis.

Until now, treatment options for phrenic nerve injury have been limited to either nonsurgical therapy or diaphragm plication, neither of which attempts to restore normal function to the paralyzed diaphragm.

Thanks to recent advances in nerve decompression and transplant leading to Dr. Kaufman’s surgical breakthroughs, it is now possible to reverse diaphragm paralysis using techniques derived from the procedures commonly used to treat arm or leg paralysis, enabling surgeons to restore function to previously paralyzed muscle groups.

The Phrenic Nerve Program is a collaboration between Reza Jarrahy, MD, at the UCLA Division of Plastic & Reconstructive Surgery and Matthew Kaufman, MD, at The Institute for Advanced Reconstruction.

How
We Can
Help

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Phrenic Nerve Reconstruction

Our specialists can utilize advanced nerve surgery techniques such as nerve decompression and nerve grafting to reconstruct the phrenic nerve and restore function to the diaphragm.
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Breathing Pacemakers for Diaphragm Paralysis

Our specialists can provide breathing pacemakers for ventilatory support for patients with certain conditions, such as high spinal cord injury and ALS (Lou Gehrig's disease), when the diaphragm no longer functions.
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Diaphragm Muscle Replacement

Our specialists can conduct diaphragm muscle replacement surgery that transforms healthy muscle from the patient's body into the chest cavity, replacing the irreversibly damaged diaphragm.

Our Mission Is To Improve The Quality Of Our Patients’ Lives

Our cutting-edge procedures have helped transform the lives of thousands of patients. Hear their stories and more about the procedure here: 
"I am extremely pleased that I'm back where I want to be."
- Stephen Video Testimonial

29 Conveniently Located Offices Across New York, New Jersey, and Pennsylvania

Shrewsbury
Shrewsbury
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535 Sycamore Ave
Shrewsbury, New Jersey 07702
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Phone: 855-980-6981
Flemington
Flemington
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194 NJ-31
Pavilion 2, Suite 102
Flemington, New Jersey 08822
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Phone: 609-608-0142
Hackettstown
Hackettstown
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57 Route 46E
Suite 201
Hackettstown, New Jersey 07840
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Phone: 855-980-6981
Lehigh Valley
Lehigh Valley
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1401 Fairmont Street
Whitehall, Pennsylvania 18052
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Phone: 855-980-6981
Montclair
Montclair
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Mountainside Medical Center (Inside Harries Pavilion) 1 Bay Avenue
Suite 4
Glen Ridge, New Jersey 07028
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Phone: 855-980-6981
Phoenixville
Phoenixville
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826 Main Street
Suite 203
Phoenixville, Pennsylvania 19460
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Phone: 855-980-6981
Brick
Brick
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74 Brick Boulevard
Building 4, Suite 205
Brick, New Jersey 08723
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Phone: 855-980-6981
East Brunswick
East Brunswick
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192 Summer Hill Rd
Suite 201
East Brunswick, New Jersey 08816
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Phone: 855-980-6981
Florham Park
Florham Park
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83 Hanover Road
Suite 260
Florham Park, New Jersey 07932
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Phone: 855-980-6981
Hopewell
Hopewell
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2 Capital Way
Suite 390, 3rd Floor
Pennington, New Jersey 08534
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Phone: 855-980-6981
New York City
New York City
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635 Madison Ave
14th Floor
New York City, New York 10022
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Phone: 855-980-6981
Rockland County
Rockland County
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257 Lafayette Ave
Suite 200
Suffern, New York 10901
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Phone: 201-967-9200
Bridgewater-Greymark
Bridgewater-Greymark
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1200 US Route 22 East
Suite 19
Bridgewater, New Jersey 08807
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Phone: 855-980-6981
Edison
Edison
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102 James Street
Suite 202
Edison, New Jersey 08820
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Phone: 855-980-6981
Freehold
Freehold
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3499 Route 9 North, Building 1
Suite 1A
Freehold, New Jersey 07728
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Phone: 855-980-6981
Egg Harbor Township
Egg Harbor Township
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4096 English Creek Ave
Egg Harbor Township, New Jersey 08234
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Phone: 855-980-6981
Hackensack
Hackensack
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20 Prospect Ave
Suite 903, 9th Floor
Hackensack, New Jersey 07601
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Phone: 551-228-2208
Montgomery
Montgomery
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700 W Germantown Pike
Suite 200
East Norriton, Pennsylvania 19403
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Phone: 855-980-6981
Union
Union
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950 West Chestnut St
Suite 102
Union, New Jersey 07083
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Phone: 855-980-6981
Marlton
Marlton
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11 Eves Drive
Suite 170
Marlton, New Jersey 08053
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Phone: 908-751-1071
Gahanna
Gahanna
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1080 Beecher Crossing N
Suite A
Gahanna, Ohio 43230
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Phone: 614-686-4083
Springfield
Springfield
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100 West Main St
Springfield, Ohio 45502
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Phone: 937-521-3900
San Francisco
San Francisco
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45 Castro Street
Suite 121
San Francisco, California 94114
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Phone: 415-565-6136
New Orleans
New Orleans
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1717 St. Charles Avenue
Rear Entrance
New Orleans , Louisiana 70130
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Phone: 504-608-7499
San Antonio
San Antonio
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9635 Huebner Rd.
San Antonio, Texas 78240
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Phone: 210-692-1181
San Antonio
San Antonio
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540 Madison Oaks
Suite 600
San Antonio, Texas 78258
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Phone: 210-558-7012
Linwood
Linwood
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222 New Road
Building 6, Suite 603
Linwood, New Jersey 08221
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Phone: 855-980-6981
Maywood
Maywood
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113 W. Essex Street
Suite 204
Maywood, New Jersey 07607
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Phone: 201-289-5551
Ridgewood
Ridgewood
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1124 East Ridgewood Ave
Suite 201
Ridgewood, New Jersey 07450
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Phone: 201-289-5551
Neptune City
Neptune City
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19 Davis Avenue
7th Floor
Neptune City, New Jersey 07753
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Phone: 732-353-1973
Livingston
Livingston
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22 Old Short Hills Road
Suite 202
Livingston, New Jersey 07039
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Phone: 609-608-0142
Somerset
Somerset
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35 Clyde Road
Suite 104
Somerset, New Jersey 08873
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Phone: 609-608-0142
Paramus
Paramus
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305 Rt 17 South
Suite 3-100A
Paramus, New Jersey 07652
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Phone: 201-967-9200
Miami
Miami
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6200 Sunset Drive
Suite 402
South Miami, Florida 33143
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Phone: 786-632-5716
Los Angeles
Los Angeles
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200 Medical Plaza
Suite 460
Los Angeles, California 90095
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Phone: 213-246-4318
McKinney
McKinney
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4510 Medical Center Dr
Suite 202
McKinney, Texas 75069
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Phone: 945-224-0926
Manahawkin
Manahawkin
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517 NJ-72
Suite K
Manahawkin, New Jersey 08050
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Phone: 609-363-2944
Cape May Court House
Cape May Court House
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106 Court House South Dennis Road
Building 200, Suite 200
Cape May Court House, New Jersey 08210
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Phone: 609-363-1174
North Bergen
North Bergen
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7650 River Road
Suite 240
North Bergen, New Jersey 07047
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Phone: 201-778-9181
Westwood
Westwood
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260 Old Hook Rd
Suite 304
Westwood, New Jersey 07675
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Phone: 855-980-6981
Fort Lauderdale
Fort Lauderdale
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2320 NE 9th St
Suite 300
Fort Lauderdale, Florida 33304
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Phone: 954-563-4500
Houston
Houston
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9230 Katy Fwy
#600
Houston, Texas 77055
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Phone: 713-489-5979
East Windsor
East Windsor
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300B Princeton-Hightstown Road
Suite 101
East Windsor, New Jersey 08512
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Phone: 609-448-6200
Woodlands
Woodlands
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18354 I-45
Suite 300
Shenandoah, Texas 77384
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Phone: 713-965-6344
Tinton Falls
Tinton Falls
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1 Executive Dr
Suite 4
Tinton Falls, New Jersey 07701
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Phone: 732-450-9700
Forked River
Forked River
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730 Lacey Road
Lacey Township, New Jersey 08731
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Phone: 609-212-4699
Hammonton
Hammonton
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219 N White Horse Pike
Suite 104
Hammonton, New Jersey 08037
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Phone: 609-363-2694

Consultation for Phrenic Nerve Reconstruction: Is it right for you?

In order to best assist you, and expedite your inquiry about our procedure, a paralyzed diaphragm should already be diagnosed.

You will be asked to provide the following information:

  • When were you diagnosed with a paralyzed diaphragm (month/year)?
  • What side(s) of your diaphragm is paralyzed?
  • Did you have surgery or trauma that caused damage to your phrenic nerve?
  • Do you experience numbness and/or tingling in your upper extremities?
  • When was your most recent SNIFF (Chest Fluoroscopy) test completed?
  • When was your most recent Pulmonary Function Test completed?
  • Have you had an EMG nerve study completed of your phrenic nerve and diaphragm?
Have questions, need more information, or would like to find out if our phrenic program is right for you? Get in touch with us today.

About
The Institute for
Advanced Reconstruction

The Institute for Advanced Reconstruction is uniquely positioned as the ‘go-to’ center for revolutionary nerve procedures, as well as world-class reconstructive treatments.

These include cutting-edge procedures such as nerve transplantation that may restore a significant degree of function for those who have suffered from stroke and other forms of paralysis. Patients who at one time believed they had exhausted their paralysis treatment options come from around the country and the globe to our practice in New York City and Shrewsbury, New Jersey.

The Institute for Advanced Reconstruction is also composed of the Axon Advance Foundation, a non-profit organization focused on new horizons in research, innovation and surgical treatments for peripheral nerve damage and spinal cord injury.

Frequently
Asked
Questions

How much of your practice is devoted to phrenic nerve surgery?

Approximately 40 percent and growing. Each case requires a lot of time. In addition to the actual procedure, there is extensive pre-surgery preparation since most of the patients are from out of town. There’s a tremendous amount of time that goes into preparing each one. To fly across the country, or from someplace else in the world, and have a unique surgery requires careful planning to maximize a successful outcome.

How common is phrenic nerve injury, and what are its causes?

It’s probably more common than most people think, but hard to know. For example, what percentage of those with this problem are finding us at The Institute for Advanced Reconstruction?

I think there are some standard causes. If you break it down into broad categories you have a surgical injury (i.e. damage to the nerve while being operated on for other causes), an anesthetic injury (e.g. inadvertent phrenic nerve damage by a needle passed into the neck), a manipulation injury (e.g. chiropractic), or some type of trauma (such as a fall from a horse, a car accident, or even a freak event such as twisting the wrong way).

What are the various factors among those requiring this procedure?

Age is a big factor for recovery; young patients regenerate better than older ones. Among our patients, the 25-50-year-olds do much better than the 60-70+-year-olds in terms of recovery.

Two-thirds to three-four of the patients are men. Men have more injuries in general—so they undergo more surgery, as well as chiropractic, and are more likely to get injured from it. Secondly, men are usually bigger and heavier—so if the neck and (big, heavy) arm twist, there is potentially more damage.

What is Idiopathic Diaphragm Paralysis?

Idiopathic Diaphragm Paralysis is the diagnosis applied when the cause of the diaphragm (breathing) paralysis is not known. For example, if there is no obvious acute trauma to the neck or chest, and there has not been any procedure or intervention that may have inadvertently caused a phrenic nerve injury.

Idiopathic Diaphragm Paralysis has traditionally been thought to occur from a “mystery” virus (often termed Parsonage-Turner syndrome or viral neuritis), however from our vast experience in evaluating thousands and treating hundreds of patients over the last fifteen years, we have clearly identified that most cases of Idiopathic Diaphragm Paralysis are actually a result of chronic peripheral nerve compression in the neck region.
Chronic nerve compression of the peripheral cervical roots and phrenic nerve is a kind of “wear and tear” phenomenon, likely related to a cumulative impact of past “mini-traumas.” Examples could include contact sports, work-related damage (e.g. manual laborers, tech-neck) or exercise injuries. Unfortunately, there is no way to accurately identify compression of these small nerve structures on an MRI. However, we do rely on cervical MRI to eliminate the possibility of spinal cord compression. We also perform complete diagnostic testing to rule out the possibility of a viral cause or a generalized neurological disorder (e.g. Amyotrophic Lateral Sclerosis, Charcot-Marie-Tooth disease).

Can you treat Idiopathic Diaphragm Paralysis with surgery?

In many cases, yes. At The Institute for Advanced Reconstruction, we have pioneered phrenic nerve reconstruction for the treatment of diaphragm paralysis. We have the world’s greatest experience in this procedure to restore functional movement to the diaphragm, including successfully treating many patients with presumed “Idiopathic Diaphragm Paralysis.”

Each patient is required to go through the necessary diagnostic testing to determine if they would be a surgical candidate.

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