Drafting Science – A 33 -year -old patient who had been paraplegic for a traumatic spinal cord lesion managed to walk again, with the help of a walker and an orthopedic device, thanks to a medullary neurostimulation therapy and rehabilitation.
The case is explained in a study published by Cell Med signed by Italian scientists and It is the first in the world that documents the recovery of the march thanks to the epidural stimulation of a patient with that type of injury.
The man suffered four years ago a medulla injury at the level of the T11 and T12 vertebrae, which also affected the core cone (terminal part of the spinal cord), which caused a serious motor deficit due to damage both in the central and peripheral nervous system.
The team of researchers led by the San Rafael hospital in the city of Milan implemented the patient a medullary neurostimulator in the epidural space and applied specific stimulation and rehabilitation protocols, which significantly improved muscle strength, march and motor control.
When they were discharged, after treatment, he was able to walk 58 meters in six minutes and complete the 10 meter test in just over 40 seconds.
Six months later, a kilometer was already walking with the only aid of a walker and an orthosis (orthopedic device) on the legs, which is qualified as “the most incredible milestone”, by the team, San Rafael hospital reported.
The neurosurgeon and the first signatory of the article, Luigi Albano, said that with the epidural electrical stimulation assisted by rehabilitation, the motor functions of “the lower extremities in a patient suffered by paraplegia could be restored (…) allowing him to achieve the upright position and walk short distances”.
In addition to motor recovery, The stimulation produced “a clinically relevant improvement of neuropathic pain and the patient’s general quality of life”added the researcher at the San Rafael Hospital.
The results of this study, according to Pietro Mortini, another of the signatories, “They offer new hopes to patients with serious medullary injuries who have experienced a long period of immobility.”by offering them the possibility of unthinkable recoveries until recently. “
The trauma of the core cone are usually cause of traffic accidents, falls or violent events and represent more than 50 % of the lesions that affect the union between the marrow and the spinal roots. Due to the areas that affect are the most difficult to treat and the options are limited.
The clinical picture can vary from one patient to another, but in most cases there are serious and persistent motors and sensory deficits that deeply affect the quality of life and autonomy.
The equipment implemented the patient between the vertebrae T11 and L1 a system of stimulation of the spinal cord with 32 electrodes, which allowed to reactivate some residual nerve circuits, in particular the essentials to recover the posture and march.
Then, he underwent an innovative rehabilitation program that integrated exercises into a virtual reality environment, using sensory and motor feedback, the hospital said.
In three months, the patient showed an improvement in the mobility of the lower extremities and the postural control of the trunk in sitting position. A process that led him to walk a kilometer.
This treatment demonstrates “how crucial teamwork is between physiotherapists, physiatrists, neurologists, neurosurgeons and engineers”, in the opinion of Sandro Iannaccone, also a signature of the study.
According to the researcher, only thanks to a close collaboration and a multidisciplinary approach, which integrates advanced neuromodulation techniques with a technological and personalized rehabilitation, “it has been possible to achieve such significant results in the patient’s motor recovery.”