Paralyzed boy's 'Christopher Reeve' surgery to make medical history at University Hospitals

A 10-year-old boy with a severe spinal cord injury will become the youngest child to undergo the surgery made famous by the late actor Christopher Reeve. The operation will allow him to breathe without a ventilator.

And it will happen here in Cleveland.

Doctors at University Hospitals Case Medical Center say the surgery, scheduled for 8 a.m. today, will make life easier for the boy, who they say is the youngest ever to receive the diaphragm pacing system developed here.

Alex Malarkey, from the small town of Huntsville, 50 miles west of Columbus, wants the surgery for several reasons.

"So I can breathe by myself," the fifth-grader said from his wheelchair, after arriving in Cleveland Thursday afternoon. "And I want to be able to smell a good plate of spaghetti." Alex can't smell because while he is on a ventilator, no air goes through his nose or mouth.

The doctor who helped develop the device and pioneered the surgery to implant it gave one more reason.

"He's never been to a movie theater because of the noise," Dr. Raymond Onders said, motioning toward the ventilator, which makes a constant swishing sound.

Like many people with quadraplegia -- paralysis of all four limbs -- Alex pulls the ventilator's clunky 60-pound battery behind his wheelchair on a special trailer. Sometimes he can't fit into elevators. He and his parents filled a 15-seat passenger van for Thursday's drive to UH.

During the outpatient surgery, expected to take about 90 minutes, doctors will thread wire-like electrodes through Alex's abdomen and attach them to his diaphragm. The electrodes will send electrical impulses to the diaphragm muscle, forcing it to contract and Alex to breathe.

The impulses come from a battery inside a 6-by-3-inch plastic box that Alex can wear in a fanny pack or attached to his chair.

One of the biggest advantages of the device is that it works on one size C lithium battery and doesn't have to be plugged into an electrical outlet the way a ventilator does.

That means no worries if bad weather knocks out the power.

Alex's parents can switch his ventilator to battery power when he's not near an electrical outlet, but the batteries last only six to eight hours. Even with four of them, his parents worry when a storm hits.

"If you don't have enough battery life, you could literally die," his mother said Thursday.

The surgery, paid for by Medicaid, has been approved for use in adults but required special permission from the U.S. Food and Drug Administration and the UH Internal Review Board before doctors could proceed with it in a child.

Onders and a team of experts at University Hospitals and Case Western Reserve University Medical School developed the device, which doctors have now implanted in about 160 people around the world.

The implant also helps patients strengthen their diaphragm muscles. At least three have now recovered enough to breathe without it.

That's what Alex's parents hope for their son, who wasn't expected to live after the car he and his father were riding in was broadsided in 2004.

"There's been three cases where people have breathed on their own without the device," said Alex's father, Kevin. "We're looking for Alex to be No. 4."

"We want him to breathe first. He'll walk later," he said, before the family left the hospital in Alex's van, with its personalized license plate.

WIL WALK, it reads.