Ruby Hall Clinic Performs Maharashtra’s First Phrenic Nerve Neuromodulation Surgery

Pune: Ruby Hall Clinic has successfully conducted Maharashtra’s first phrenic nerve neuromodulation surgery, helping a 58-year-old patient breathe independently after six months of mechanical ventilator dependency due to a critical spinal injury. This groundbreaking procedure sets a new benchmark in neurosurgical and critical care in India.

The patient, Sanjay Yashwant Pai, suffered a C3-C4 vertebral fracture on July 25, 2024, after a bathroom fall. Despite undergoing multiple spinal surgeries — including corpectomy, discectomy, and spinal fusion — at another facility, he remained quadriplegic and fully dependent on ventilator support due to spinal cord compression and anterior subluxation.

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He was admitted to Ruby Hall Clinic on September 19, 2024, under the care of Dr. Kapil Zirpe, Head of Neuro Trauma, and Dr. Manish Baldia, Consultant Functional Neurosurgeon. At the time, he was conscious, receiving nutrition via a PEG tube, and under antibiotic therapy. Due to the life-threatening risks associated with prolonged ventilator use — such as pneumonia, ulcers, and thromboembolism — the medical team opted for an advanced procedure: phrenic nerve neuromodulation.

Dr. Manish Baldia explained, “Even after extensive rehabilitation efforts, we could not successfully wean the patient off the ventilator. Through this rare and delicate surgery, we implanted a device near the phrenic nerve, enabling external remote stimulation of the diaphragm. This gradually strengthened the patient’s breathing muscles and allowed him to breathe on his own.”

This marked a critical turning point. Pai showed steady respiratory improvement post-surgery and was eventually weaned off the ventilator. By April 28, 2025, he was moved from ICU to the general ward, breathing independently.

Dr. Parvez Grant, Chairman and Managing Trustee, Ruby Hall Clinic, said, “Innovation and patient-first care lie at the heart of Ruby Hall Clinic. This successful phrenic nerve neuromodulation surgery demonstrates our commitment to advancing life-saving treatments and giving patients a second chance.”

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Pivotal Role of Ruby Hall Clinic

The ICU Team (NTU2) at Ruby Hall Clinic played a pivotal role in the successful execution of this complex case, setting a new standard in spinal injury treatment and critical care in the state.