There will be a lead-in period of at least 1 month period of clinical evaluations before surgery to estimate the slope of decline of clinical status. Measures during this lead-in time will be the ALSFRS-R, hand-held dynamometry/grip strength, Ashworth Spasticity Scale, VC and NIF, EIM, and diaphragm ultrasound.Subjects will be followed postoperatively at 2 and 4 weeks, and then at 3, 6, 9, 12, 15, 18, 21, and 24 months, and then at every 6 months thereafter until death.