A ray of hope for catastrophic spinal injuries

A team at the University of Louisville have combined epidural stimulation of the spinal cord (the application of continuous electrical current at varying frequencies and intensities to specific locations on the lumbosacral spinal cord), with locomotor training to help two severely paralysed patients to walk again. Locomotor training retrains the spinal cord to “remember” the pattern of walking by repetitively practicing standing and stepping.
Author of the study, Susan Harkema said: “This research demonstrates that some brain-to-spine connectivity may be restored years after a spinal cord injury as these participants living with motor complete paralysis were able to walk, stand, regain trunk mobility and recover a number of motor functions without physical assistance when using the epidural stimulator and maintaining focus to take steps.”
A team from the Mayo Clinic and the University of California, Los Angeles has used an implanted spinal cord stimulator to help a man paralysed from below the middle of his torso for 5 years to stand and walk with assistance.
The patient’s spinal cord is injured at the thoracic vertebrae in the middle of his back, and team implanted an electrode into the epidural space at a specific location below the injured area, which connects to a pulse generator device under the skin of the patient’s abdomen and communicates wirelessly with an external controller. The researchers then adjusted stimulation settings, trainer assistance, harness support and treadmill speed over a period of 113 rehabilitation sessions, resulting in the patient being able to walk over ground using a front-wheeled walker and step on a treadmill placing his arms on support bars to help with balance. By 25 weeks the patient was able to dispense with the harness entirely and only needed help every now and then from the trainers. When stimulation was off, the patient remained paralysed.
Kendall Lee, M.D., Ph.D., co-principal investigator, neurosurgeon and director of Mayo Clinic’s Neural Engineering Laboratories, said: “What this is teaching us is that those networks of neurons below a spinal cord injury still can function after paralysis.”