Gorgey Ashraf S, Gouda Jan J
Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, 1201 Broad Rock Boulevard, Richmond, VA 23249, USA.
Department of Physical Medicine & Rehabilitation, Virginia Commonwealth University, Richmond, VA 23298, USA.
J Clin Med. 2022 Aug 30;11(17):5120. doi: 10.3390/jcm11175120.
A 25-year-old male with T3 complete AIS A was implanted with percutaneous spinal cord epidural stimulation (scES; eight contacts each) leads and a Medtronic Prime advance internal pulse generator. The two leads were placed at the midline level to cover the region of the T11-T12 vertebrae. Five days after implantation, X-ray showed complete migration of the left lead outside the epidural space. Two weeks after implantation, reprogramming of the single right lead (20 Hz and 240 µs) after setting the cathode at 0 and the anode at 3 resulted in target activation of the abdominal muscles and allowed for the immediate restoration of trunk control during a seated position, even with upper extremity perturbation. This was followed by achieving immediate standing after setting the single lead at -3 for the cathode and +6 for the anode using stimulation configurations of 20 Hz and 240 µs. The results were confirmed with electromyography (EMG) of the rectus abdominus and lower extremity muscles. Targeted stimulation of the lumbosacral segment using a single lead with a midline approach immediately restored the trunk control and standing in a person with complete paraplegia.
一名25岁的T3完全性AIS A级男性患者植入了经皮脊髓硬膜外刺激（scES；每根有8个触点）电极和美敦力Prime Advance植入式脉冲发生器。两根电极置于中线水平，覆盖T11 - T12椎体区域。植入后5天，X线显示左侧电极完全移出硬膜外间隙。植入后两周，在将阴极设为0、阳极设为3后，对单根右侧电极进行重新编程（20 Hz和240 µs），导致腹部肌肉目标激活，并使患者在坐位时即使在上肢受到干扰的情况下也能立即恢复躯干控制。随后，使用20 Hz和240 µs的刺激配置，将单根电极的阴极设为 - 3、阳极设为 + 6后，患者立即实现站立。腹直肌和下肢肌肉的肌电图（EMG）证实了这些结果。采用中线入路使用单根电极对腰骶段进行靶向刺激，立即恢复了一名完全性截瘫患者的躯干控制和站立能力。
