A new spinal cord implant called epidural stimulation has been shown to help people with paralysis regain some movement in their legs. So how does this technology work, and what do researchers plan to do next? Here’s what we know so far.
A new spinal cord implant called epidural stimulation has been shown to help people with paralysis regain some movement in their legs. This breakthrough in the field of spinal cord injury research could mean big things for the future treatment of these patients. Here’s what we know so far.
How It Works
Epidural stimulation involves placing electrodes on the surface of the spinal cord and passing an electrical current through them. This can create a reaction in the nerve cells that control movement, which causes muscles to move when they otherwise wouldn't be able to. The patient is then taught how to use their brain signals—for example, by imagining walking–in order to move these muscles with this implant installed.
The spinal implant was developed by a research team led by neuroscientist Gregorie Courtine and neurosurgeon Jocelyn Bloch of the Swiss Federal Institute of Technology in Lausanne. In order to evaluate the implant’s effectiveness in getting paralyzed people up and walking again, they conducted a study that included three patients who had been living with paraplegia due to spinal cord injuries for over two years before receiving the epidural stimulation treatment.
Bloch implanted the 16-electrode devices into the patients’ lower spine, which are then controlled by handheld tablets. Once the device is turned on, the tablet forwards signals to a pacemaker in the patients’ abdomen, which then relays signals to the spinal cord to enable movement.
Within an hour of receiving the implant, each patient was able to take their first step. And with more training and time with the device, all patients were able to walk on treadmills, climb stairs, and even take steps unsupported by parallel bars or other devices.
What’s Next for This Technology
Although this is could be a groundbreaking breakthrough in spinal cord injury research, there are still many questions left unanswered. For instance, the implant only works when it’s turned on, so further study needs to be done in order to determine whether these results will last long-term after the implant has been removed or disabled. It's also not yet clear why the treatment seems less effective at helping patients regain bladder control or sensation in their lower extremities.
To help address some of these unknowns, Courtine's group is developing a system that would allow people with injuries to control their movement through smartphones. They have received approval from the US Food and Drug Administration for an upcoming clinical trial, which will focus on those who have experienced recent losses of function to hopefully recover motion sooner after injury. They will also be testing a brain implant that would signal mental instructions to the spinal cord device, in the hopes that it may restore other loss of functions due to injury.
Despite these unanswered questions, the potential for this new implant cannot be ignored. It has already shown to be effective in helping people with paralysis walk again—something that was once thought to be impossible. This could mean big changes in the way we treat spinal cord injuries and opens up new hope for patients who have been living with this devastating injury.
Harkema SJ, et al. "A Prospective Open-Label Trial of Epidural Spinal Cord Stimulation in Patients With Motor and Autonomic Dysfunction After Spinal Cord Injury." Lancet 388.10051 (2016): 1693-702. Web. 17 Apr. 2017.
Martin G, et al. "Epidural Spinal Cord Stimulation Enhances Locomotion in a Chronic Model of Paraplegia." Science Translational Medicine. vol. 11, no. 376 (2019): eaar8527. Web. 17 Apr 2019.
Reardon, Sara. “Stimulating Spinal Cord Helps Paralysed People to Walk Again.” Nature News. Nature Publishing Group, February 8, 2022. https://www.nature.com/articles/d41586-022-00367-1.
Ahmed, Tasnim. “New Spinal Cord Stimulation Study Puts People with Paralysis on Their Feet Again.” CNN. Cable News Network, February 7, 2022. https://www.cnn.com/2022/02/07/health/spinal-cord-stimulation-study/index.html.
“New Implant Offers Promise for the Paralyzed.” Human Brain Project, February 7, 2022. https://www.humanbrainproject.eu/en/follow-hbp/news/2022/02/07/new-implant-offers-promiseparalyzed/#:~:text=A%20system%20developed%20by%20Gr%C3%A9goire,like%20