Spinal cord stimulation for spinal cord injury patients with paralysis: To regain walking and dignity

• Main Authors: Sheng-Tzung Tsai, Yu-Chen Chen, Hung-Yu Cheng, Chun-Hsiang Lin, Huan-Chen Lin, Chich-Haung Yang, Chung-Chao Liang, Shin-Yuan Chen
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Tzu-Chi Medical Journal
• Subjects: paralysis; spinal cord injury; spinal cord stimulation
• Online Access: http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2021;volume=33;issue=1;spage=29;epage=33;aulast=Tsai
• ISSN: 1016-3190; 2223-8956

Spinal cord injury (SCI) usually leads to disconnection between traversing neuronal pathway. The impairment of neural circuitry and its ascending and descending pathway usually leave severe SCI patients with both motor disability and loss of sensory function. In addition to poor quality of life, SCI patients not only have disabling respiratory function, urinary retention, impaired sexual function, autonomic dysregulation but also medical refractory neuropathic pain in the long term. Some translational studies demonstrated that spinal networks possess a dynamic state of synaptic connection and excitability that can be facilitated by epidural spinal cord stimulation. In addition, preliminary human studies also confirmed that spinal cord stimulation enables stepping or standing in individuals with paraplegia as well. In this review, we examined the plausible interventional mechanisms underlying the effects of epidural spinal cord stimulation in animal studies. Following the success of translational research, chronic paralyzed subjects due to SCI, defined as motor complete status, regained their voluntary control and function of overground walking and even stepping for some. These progresses lead us into a new hope to help SCI patients to walk and regain their independent life again.