Afridi Abdullah K, Steele Alexander G, Martin Catherine, Sayenko Dimitry G, Barber Sean M
Texas A&M School of Engineering Medicine, Houston, Texas.
Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, Texas.
J Neurosurg Case Lessons. 2024 Sep 16;8(12). doi: 10.3171/CASE24155.
Spinal cord stimulation (SCS) has demonstrated potential as a therapy to enhance motor functional recovery after spinal cord injury (SCI). Epidural SCS for motor recovery is traditionally performed via the dorsal electrode. While ventral epidural stimulation may provide more direct and specific stimulation of the ventral motor neurons involved in motor control, it is largely unstudied, and its role in motor recovery after SCI is unclear. In order to profile the safety and feasibility of ventral epidural spinal stimulation (VSS), the authors present a patient who underwent VSS following a corpectomy to treat SCI related to metastatic epidural cord compression.
A patient underwent transpedicular corpectomy for spinal cord decompression, as well as the placement of 2 ventral epidural electrodes, followed by concurrent physical therapy and ventral epidural stimulation. He was nonambulatory preoperatively but was able to walk over 300 feet with the assistance of a rolling walker at the conclusion of the 3-week study period. VSS was noted to produce improvements in muscle contraction when stimulation was on.
VSS appears to be safe, feasible, and well tolerated. VSS, as compared to standard-of-care therapy for SCI, can be used in conjunction with physical therapy and may lead to improvements in motor function. https://thejns.org/doi/10.3171/CASE24155.
脊髓刺激（SCS）已显示出作为一种疗法来促进脊髓损伤（SCI）后运动功能恢复的潜力。传统上，用于运动恢复的硬膜外脊髓刺激是通过背侧电极进行的。虽然腹侧硬膜外刺激可能对参与运动控制的腹侧运动神经元提供更直接和特异性的刺激，但这在很大程度上尚未得到研究，其在SCI后运动恢复中的作用尚不清楚。为了描述腹侧硬膜外脊髓刺激（VSS）的安全性和可行性，作者介绍了一名在椎体次全切除术后接受VSS治疗与转移性硬膜外脊髓压迫相关的SCI患者。
一名患者接受了经椎弓根椎体次全切除术以进行脊髓减压，并放置了2个腹侧硬膜外电极，随后同时进行物理治疗和腹侧硬膜外刺激。他术前不能行走，但在为期3周的研究结束时，在滚动助行器的辅助下能够行走超过300英尺。观察到VSS在刺激开启时可使肌肉收缩得到改善。
VSS似乎是安全、可行且耐受性良好的。与SCI的标准治疗相比，VSS可与物理治疗联合使用，并可能改善运动功能。https://thejns.org/doi/10.3171/CASE24155。
