Curious about epidural stimulation for spinal cord injury?
We’ve put together an easy guide with answers to all your questions and more.
We’ll go over the good, bad, and everything in between to help you decide if epidural stimulation is right for you.
Let’s get started!
What is Epidural Stimulation?
Epidural stimulation for spinal cord injury requires invasive surgery.
By implanting a stimulator and 16-electrode array into the spinal cord’s lumbosacral region, you can release electric currents into your spinal cord with the click of a button.
Spinal cord injury results in a disruption between your brain and spinal cord.
Basically, the messages from your brain can’t travel past the site of injury and your body can’t react.
This is where the electric currents come in! They mimic the brain signals and excite the circuits below the injury site.
Therefore, your body is able to receive messages and regain motor function.
The History of Epidural Stimulation for Spinal Cord Injury:
Here’s a quick overview of some important research about epidural stimulation:
Exciting the Spinal Cord to Enhance Movement
In 2011, a study was published by Susan Harkema on epidural electrical stimulation of the spinal cord to enhance voluntary movement in paraplegics.
Before this, the main function of electric stimulation was to alleviate chronic pain.
This study took a different approach and tested its effects on exciting the spinal cord.
They used epidural stimulation on a patient with an incomplete paralysis who had no motor function but some sensory function.
After 7 months of physical therapy, the patient was able to move his legs, but only with the stimulator running.
Epidural stimulation was able to help activate circuits in the spinal cord that have been weakened from injury and promote spasticity after spinal cord injury.
Expanding the Research Pool
Three years later, a follow-up to the study yielded 3 more SCI patients who’ve regained voluntary movement with the help of epidural stimulation. All 3 were motor complete and 2 were also sensory complete.
Like the previous study, voluntary movement was only possible with the stimulator on.
With continuous stand or step training, the patients required lower stimulation voltages to perform the same movements.
The repetitive training and epidural stimulations increase the plasticity of weak circuits in the spinal cord, making them more functional.
As a result, spinal cord injury patients with complete loss of motor function can regain voluntary control of muscles by altering nerve circuits in the spinal cord with epidural stimulation.
A recent 2018 follow-up reports that 2 out of 4 motor complete spinal cord injury patients were able to recover over-ground walking with the help of support devices. However, mobility still could not occur without electrical stimulation.
A consistent combination of epidural stimulation and intense physical training over several years is showing great promise.
It’s become clear that electric stimulation is necessary to promote motor function. Physical therapy alone hasn’t been able to recover movement.
It’s like how gas is essential to drive a car. Your engine can be in perfectly good condition, but without gas for fuel, it won’t start. Electric stimulation seems to be crucial in activating the rest of the spinal cord.
What are the Side Effects of Epidural Stimulation for Spinal Cord Injury?
Epidural stimulation is starting to sound a little too good to be true right?
Here are some of the potential pros and cons that’ll help you decide if it’s worth it.
Potential Positive Effects of Epidural Stimulation:
- Pain relief: Electrical stimulation is mainly used to relieve chronic pain. It doesn’t get rid of the source, but it changes the way your brain reacts to pain.
Refer to our article on pain after spinal cord injury to find out what kind of pain you might be experiencing and other treatments.
- Reversibility: If you ever decide that epidural stimulation is not for you, you can always remove the implants.
- Increased bowel, bladder, and sexual function: by activating spinal cord circuits that affect the urinary tract, pelvic floor, and bowel. This means more control and fewer accidents!
- Normalization of Blood Pressure: Many spinal cord injury patients experience hypotension (low blood pressure). This study found that epidural stimulation can activate mechanisms that increase and stabilize blood pressure, resulting in less fatigue, dizziness, and shortness of breath.
- Improved State of Mind: When undergoing a process like epidural stimulation, every little improvement is encouraging. This creates a more hopeful mentality and overall, patients become more positive regarding recovery.
Potential Negative Effects of Epidural Stimulation:
- Device Problems: Lead migration (when the lead moves to a different location, which results in ineffective stimulation) and breakage appear to be the most common device-related issues.
- Invasiveness: Because epidural stimulation requires surgery, you should also expect the general risks that come with any surgical procedure like infections or bleeding.
- Cost: This report claims that the average cost of treatment per patient ranges from $19,246-$47,190. It’s a wide price range, but keep in mind that every spinal cord injury is unique to the individual’s condition.
- No Guarantees: Although promising, the mechanisms behind electrical stimulation for spinal cord injury have yet to be fully understood. Not everyone will experience the same results. Sometimes you can have a successful trial, but fail to experience the same results longterm.
- Discomfort: You may feel some discomfort from the stimulator itself or the electric currents it emits.
That’s a wrap! Now that you know a little more about epidural stimulation for spinal cord injury, you can decide if it’s right for you.
Research and technologies for epidural stimulation are continuously developing, so there’s no doubt that a bright future lies ahead for spinal cord injury patients.