Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA.
Virginia Commonwealth University, Department of Physical Medicine & Rehabilitation, Richmond, VA, 23298, USA.
Nat Commun. 2023 Apr 12;14(1):2064. doi: 10.1038/s41467-023-37845-7.
Two persons with chronic motor complete spinal cord injury (SCI) were implanted with percutaneous spinal cord epidural stimulation (SCES) leads to enable motor control below the injury level (NCT04782947). Through a period of temporary followed by permanent SCES implantation, spinal mapping was conducted primarily to optimize configurations enabling volitional control of movement and training of standing and stepping as a secondary outcome. In both participants, SCES enabled voluntary increased muscle activation and movement below the injury and decreased assistance during exoskeleton-assisted walking. After permanent implantation, both participants voluntarily modulated induced torques but not always in the intended directions. In one participant, percutaneous SCES enabled motor control below the injury one-day following temporary implantation as confirmed by electromyography. The same participant achieved independent standing with minimal upper extremity self-balance assistance, independent stepping in parallel bars and overground ambulation with a walker. SCES via percutaneous leads holds promise for enhancing rehabilitation and enabling motor functions for people with SCI.
两名患有慢性运动完全性脊髓损伤（SCI）的患者接受了经皮脊髓硬膜外刺激（SCES）导线植入术，以实现损伤以下的运动控制（NCT04782947）。通过一段时间的临时植入和永久性 SCES 植入，进行了脊髓映射，主要是为了优化配置，以实现运动的自主控制，并将站立和行走作为次要结果进行训练。在两名参与者中，SCES 使损伤以下的肌肉激活和运动增加，并在外部骨骼辅助行走时减少辅助。永久性植入后，两名参与者都能自主调节诱导扭矩，但并非总是按预期方向调节。在一名参与者中，通过临时植入后一天的经皮 SCES 实现了损伤以下的运动控制，这一点通过肌电图得到了证实。同一名参与者实现了独立站立，仅需最小的上肢自我平衡辅助，在平行杆上独立行走，以及使用助行器在地面上行走。经皮导线的 SCES 有望增强 SCI 患者的康复和运动功能。
