Mbaka first in area to implant breathing device in patient with quadriplegia

Maryann Mbaka, M.D., an assistant professor of surgery, right, performed the minimally invasive procedure, giving the patient a better chance for recovery and an improved quality of life. 

In the first procedure of its kind in the area, a USA Health surgeon has implanted a diaphragm pacer in the abdomen of a patient with quadriplegia, enabling the patient to breathe without a ventilator.

Maryann Mbaka, M.D., a trauma and emergency general surgeon at USA Health and an assistant professor of surgery at the Whiddon College of Medicine, performed the procedure Nov. 7 at USA Health University Hospital.

“The goal with this procedure is to liberate patients with spinal cord injuries from mechanical ventilation as soon as possible,” Mbaka said. “This gives them a better chance for recovery and an improved quality of life, which is great news for patients.”

During the minimally invasive procedure, a surgeon places small electrodes – part of the NeuRX Diaphragm Pacing System – in areas near the phrenic nerves that control the diaphragm, the major muscle used in breathing.

The electrodes connect to a small battery-powered device that stimulates the muscle and phrenic nerves to cause the diaphragm to contract and pull air into the lungs, mimicking the body’s natural breath cycle. By contrast, a ventilator uses forced air to help a patient breathe. The NeuRX DPS device can be used for at least four hours a day, and, in many cases, continuously.

“I am so thankful that Dr. Mbaka works at USA Health. Her forward thinking and excellent surgical skills allow us to offer the most leading-edge technology and operations for our patients,” said Jon D. Simmons, M.D., chief of trauma, acute care surgery and burn at USA Health. “The placement of the first diaphragmatic pacer in our region is a perfect example of the impact an academic healthcare system can have on our community.”

Mbaka said the patient was discharged from the hospital in less than three weeks. “This is a major milestone given that quadriplegic patients typically would be in the ICU for months or, in most cases, could never be liberated from the ventilator,” she said.

Studies have shown that ventilator dependence significantly decreases life expectancy in patients with spinal cord injuries. “Being freed from a ventilator reduces the risk of pressure injuries and infections,” Mbaka said. “It also allows for earlier physical rehab, which results in better patient outcomes.”

First implanted during a prospective clinical investigation in 2000, the NeuRX DPS has been used in more than 2,500 patients worldwide. The late actor Christopher Reeve was one of the first recipients. The FDA granted premarket approval for patients with spinal cord injuries in 2023, enabling the device to be more widely available.

Faculty, medical student publish article on neonatal birth fractures in academic journal

Figure A: AP radiograph of a newborn female with a displaced left clavicle shaft fracture. Figure B: AP radiograph of the same patient at age 10 weeks. Note the clavicle has regained its anatomic shape and is remodeling nicely.

A review article on neonatal birth fractures by two USA Health orthopaedic surgeons and a medical student has been published in the Journal of the Pediatric Orthopaedic Society of North America. 

The article reviews the incidence, risk factors and treatment for various fractures that can be sustained by an infant during the delivery process. The authors are Tyler C. McDonald, M.D., and William A. Cutchen, M.D., both pediatric orthopaedic surgeons at USA Health and assistant professors of orthopaedic surgery; and C. Lake Higdon, a third-year medical student at the Whiddon College of Medicine. 

Overall, birth fractures in babies are rare, occurring at a rate of about 0.23 per 1,000 live births, but fractures can be missed initially. McDonald said the article is intended to provide more information on the topic for those who care for neonates.  

“Having a healthy respect for these injuries and staying informed on the various types of neonatal birth fractures that can occur – especially the rare ones – are important,” McDonald said. “Timely recognition allows for earlier treatment, and earlier treatment typically leads to better outcomes.” 

The article summarizes various types of relatively common fracture patterns, such as clavicle fractures, and some uncommon fracture patterns, such as distal femoral physeal fractures, in which a break occurs at the growth plate located at the lower end of the thigh bone.  

In the case of clavicle fractures, infants with a painful arm range of motion can be gently swathed with a soft bandage or have their sleeve pinned to their shirt and have an excellent prognosis, the article said. 

With distal femoral physeal fractures, which are rarer, the authors advocate for a nonoperative treatment that calls for immobilizing injuries that are nondisplaced or in the process of healing. Providers may also attempt to set the bone with or without an operation when a fracture is diagnosed immediately, the article said. 

Read the full article: “Neonatal Birth Fractures.”

Doc Rock band spotlight: The Grey Scrubs

The Grey Scrubs are raising funds for the Division of Medical Education.

Don’t miss the fourth annual Doc Rock “battle of the bands” event at the Soul Kitchen in downtown Mobile on Thursday, Jan. 30, 2025. The friendly competition helps support research and critical clinical needs at USA Health. 

At least one member of each of the five bands has an affiliation with USA Health or the Whiddon College of Medicine. The Grey Scrubs — made up of fourth-year medical students Danner Butler, Connor Martin, Cade Smelley, Will Smith and Matt Watterson — are raising funds for the Whiddon College of Medicine's Division of Medical Education. 

The band unofficially formed in 2021 during a couple of afternoon jam sessions. Taking on the name The Grey Scrubs, the group decided to make it official to participate in the Doc Rock battle. 

The band's bio describes their sound: “A high-energy group with a classic rock feel, The Grey Scrubs stand united by their love of music and are ready to challenge the mighty Doc Rock competition, hoping to end their final year of medical school with a bang.”

Buy tickets for the show and support your favorite band at Doc Rock. 

Neonatologist Ikeri selected for national award

Kelechi Ikeri, MBBS

USA Health Children’s & Women’s Hospital neonatologist Kelechi Ikeri, MBBS, has been named one of five national recipients of the prestigious American Academy of Pediatrics/Vermont Oxford Network (AAP/VON) Scholars Award.

The award recognizes future leaders in newborn care who exemplify dedication to data-driven quality improvement in the care of infants and families. It is presented to five fellows and early-career neonatologists in partnership with the American Academy of Pediatrics Section on Neonatal Perinatal Medicine.

“We are immensely proud that Dr. Ikeri’s contributions to the care of sick and premature infants in our community have received national recognition,” said Maran Ramani, M.D., head of the neonatology division at Children’s & Women’s Hospital. “This award places him among a distinguished group of emerging physicians. We eagerly anticipate his future achievements in enhancing outcomes for our smallest patients.”

Scholars selected for this award receive a stipend to attend the Annual Quality Congress (AQC) meeting and present research during a webinar in 2025. Ikeri’s biography will also be posted on the Vermont Oxford Network website along with the other winners.

An assistant professor of pediatrics at the Whiddon College of Medicine, Ikeri was drawn to work at USA Health because of the patient population’s wide range of complexity and cases.

Ikeri also serves as the neonatal physician lead for the Alabama Perinatal Quality Collaborative, a state perinatal program initiated by the Alabama Department of Public Health and funded by the state and federal government and the Centers for Disease Control and Prevention.

Born in Nigeria, he earned a bachelor of medicine and surgery degree from the University of Lagos College of Medicine in Idi-Araba in Lagos, Nigeria. An interest in critical care medicine, he said, attracted him to neonatology.

He worked in hospitals in Nigeria and the island of Tobago before moving to the United States in 2015. Ikeri completed a pediatrics residency at Woodhull Medical and Mental Health Centre in Brooklyn, New York, in 2018 and completed a neonatal-perinatal medicine fellowship at St. Christopher’s Hospital for Children in Philadelphia in June 2021.

Ikeri is certified in general pediatrics and neonatology by the American Board of Pediatrics and is a member of the American Academy of Pediatrics, American Medical Association, and American College of Medical Quality.

Medical student presents research on peer-led academic support at national conference

Robert Cole Barefoot, right, with mentor David S. Williams, Ph.D., presents a poster at the Medical Education Learning Specialist annual meeting. 

Third-year medical student Robert Cole Barefoot recently presented research on peer-led academic support in medical school at the 2024 Medical Education Learning Specialist (MELS) annual meeting, held Nov. 7-8 at the Emory University Conference Center in Atlanta. Barefoot’s work was completed under the mentorship of David S. Williams, Ph.D., assistant dean of institutional and academic success at the Whiddon College of Medicine.

His poster, titled “Content Question Coaching: A Peer-Led Program to Enhance Self-Efficacy in Medical Students,” explored the design and impact of an innovative academic support initiative created through the Peer Academic Leaders (PALs) program. The initiative, known as Content Question Coaching (CQC), engages second-year medical students as facilitators to guide first-year students in evidence-based study strategies and interactive sessions using peer-written content questions. CQC emphasizes collaboration and high-yield content identification to strengthen students' confidence and academic success.

“My goal in designing this program was to help ease the transition from college to medical school because I know how hard it can be,” Barefoot said.

Through a mixed-methods approach, Barefoot assessed the program’s effectiveness in improving participants’ self-efficacy and study strategies. Data collected from four CQC sessions highlighted high levels of general self-efficacy among participants and reported improvements in applying evidence-based learning techniques. Feedback also revealed that students gained confidence in identifying key information and tackling practice questions with greater clarity.

“This research demonstrates the immense value of leveraging peer leaders to support medical education,” Williams said. “Programs like Content Question Coaching not only enhance the academic success of first- and second-year students but also provide peer academic leaders with critical opportunities to grow as educators and future physicians.”

The CQC program will continue to support both first- and second-year students, ensuring its lasting impact on the Whiddon College of Medicine’s learning environment, Williams added.