SPINAL IMPLANTS FOR SEVERE PARALYSIS: A BREAKTHROUGH TECHNOLOGY
One of the major concerns after an accident that causes spinal cord injury is whether the patient will ever be able to walk again.
A spinal cord injury is a traumatic experience that affects the individual not only physically, but also emotionally, mentally, and socially.
So far, paralysis from spinal cord trauma remains incurable. Treatments have focused on rehabilitation and different forms of therapy to help people with spinal cord injuries lead more independent and productive lives.
Recently, new technology has enabled patients with severe paralysis to regain some of their lost motor functions. Using spinal implants and electrical stimulation, scientists were able to help patients with severe spinal cord injuries restore voluntary motor impulses within only one day after turning on their devices.
This recent advancement in the management of paralysis does not cure spinal cord injury. However, it raises new hope for achieving everyday mobility and more physical independence in patients with severe spinal cord injuries.
Paralysis is the loss of voluntary muscle movements in a part of your body because of a problem in the nervous system.
Usually, the brain communicates with the body through the central nervous system to cause movement. The spinal cord is a part of the central nervous system that carries movement commands from the brain to your body parts.
Paraplegia, paralysis of the lower limbs, is most commonly caused by an injury to the spinal cord.
An accident or a trauma can cause damage to the spinal cord that prevents nerve impulses from reaching the muscles. Without those impulses, your muscles won’t be able to contract to move certain body parts, resulting in paralysis.
Unfortunately, permanent paralysis isn’t curable, and there is no way to reverse a spinal cord injury. However, researchers are continuously working on new possible treatments that can improve body functions and quality of life after damage to the spinal cord.
The following interventions may provide some level of improvement to paralysis patients:
- Surgery to decompress the spinal cord: This type of surgery is done to remove fluid, blood, tissue, or foreign objects that may be compressing the spinal cord. Although it doesn’t reverse spinal cord damage, decompression surgery could prevent pain or the progress of the neurologic deficit.
- Steroids: Steroid injections in the early hours after spinal cord injury can decrease the extent of paralysis during the patient’s life.
- Physical therapy: Muscle strengthening and mobility exercises can improve the ability of patients with paralysis to perform activities with limited assistance.
- Occupational therapy: Occupational therapy allows paralyzed patients to improve their fine motor skills and better perform everyday activities.
- Use of assisted devices: Mobility devices, such as braces, crutches, mobile scooters, and wheelchairs can aid with moving around.
- Recreational therapy: Recreational activities and sports can improve mobility skills and nourish social relationships in patients after severe spinal injury.
- Traction: A physical therapist realigns the spine either manually (by hand) or using special tools to relieve some of the pressure off the spine and stabilize it.
The management of paralysis will depend on the underlying cause of the paralysis and the severity of the spinal cord damage.
Recently, a team of researchers has offered new hope in the form of spinal implants to people with paralysis.
A spinal cord stimulator is a technological device surgically implanted in the spinal cord. This device consists of electrodes (thin wires that conduct electricity) in the spinal cord and a generator (battery) placed under the skin of the abdomen.
Spinal cord stimulators were first developed to relieve different types of chronic pain, including back pain.
The implant is placed between the spinal cord and the vertebrae and can send low levels of electricity directly into the spinal cord to decrease pain. That is known as epidural electrical stimulation (EES).
Dorsal nerve roots along the spinal cord allow the neural signals coming from the brain to pass through the spinal cord and trigger leg and torso movements.
A spinal cord trauma can severely damage the nerves in a person’s spinal cord. As a result, the brain’s neural signals that command movement can no longer pass through and reach the body’s muscles, causing paralysis.
Spinal cord stimulation can recreate the communication between the brain and spinal cord interrupted by the injury and restore limb movement.
Spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis: A breakthrough technology
A group of scientists designed electrodes that can reach the dorsal nerve roots in the spinal cords that control the movement of the trunk and torso.
Then, the team designed a brain-computer interface technology that collects movement commands from the brain, activates the spinal electrodes, and translates the brain signals into movement commands.
They also developed software that can stimulate the spinal electrodes in activity-specific patterns that allow the patient to perform different movements, such as standing up, stepping, and walking.
They tested this new neurotechnology in three men with severe spinal cord injuries who became paralyzed after motorcycle accidents. Within one day of stimulation, all three men were able to stand, walk, swim, cycle, and control their trunk movement with assistance. After 4 to 6 months, all three individuals could walk across the ground using only a walker for support.
These fast results were remarkable in patients with such severe spinal cord injuries. Daily movement with the help of epidural electric stimulation has significant health implications for patients with spinal cord injuries. It can improve heart functions, increase bone density, lower the risk of pressure injuries from sitting too much, and improve bowel and bladder control.
The team of researchers is using different stimulation patterns to enable patients to perform a wide range of activities, such as swimming, sitting forward, bending, doing leg presses, and even climbing stairs.
For now, individuals need to use a tablet to select the movement command they want. The tablet then sends the commands via Bluetooth to a transmitter worn around the waist. The transmitter signals the generator implanted in the abdomen, which then activates the electrodes in the spine and induces movement.
To simplify this process for users, medical technology companies plan to design devices that allow users to activate the generator by giving voice commands to a smartwatch.
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- Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis | Nature Medicine
- Epidural electrical stimulation effectively restores locomotion function in rats with complete spinal cord injury - PMC
- Anatomy, Central Nervous System - StatPearls - NCBI Bookshelf
- Steroids for acute spinal cord injury - PMC
- Physical therapy after spinal cord injury: A systematic review of treatments focused on participation - PMC
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