Ever heard of epidural stimulation for spinal cord injury? It’s a type of treatment that uses electric currents to excite neurons below your level of injury amd promote movement.
Believe it or not, people who have never been able to walk since their spinal cord injury have had successful results with epidural stimulation.
This article will go over the history, pros, and cons of epidural stimulation as an SCI treatment.
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.
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, so you may not be able to move areas below your level of injury.
This is where the electric currents come in. They mimic brain signals and excite the circuits below the injury site.
Therefore, areas below your level of injury can receive stimulation and potentially move again!
The History of Epidural Stimulation Treatment
To help you better understand the development of epidural stimulation as a treatment for spinal cord injury, let’s go over its history.
Here’s a quick overview of some important research about epidural stimulation:
Finding a New Use for Electric Stimulation
In 2011, a study was published by Susan Harkema on epidural electrical stimulation of the spinal cord to enhance voluntary movement in individuals with paraplegia.
Before this, electric stimulation was primarily used 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.
Testing Epidural Stimulation on More Spinal Cord Injury Patients
Three years later, a follow-up study resulted in 3 more SCI patients regaining 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 achieved when the stimulator was on.
With continuous stand and step training, the patients gradually required lower stimulation voltages to perform the same movements.
The repetitive training paired with epidural stimulation increased the plasticity of weak circuits in the spinal cord, making them more functional.
As a result, spinal cord injury patients who were unable to move at all below their level of injury were able to regain voluntary control of muscles by stimulating adaptive changes in the spinal cord.
Epidural Stimulation and Time Since Spinal Cord Injury
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 plays a crucial role in promoting motor function, especially when physical therapy alone isn’t yielding any results.
Repetitive movement is key, but epidural stimulation seems to provide that extra boost to get things going.
Side Effects of Epidural Stimulation for Spinal Cord Injury
It’s important to understand that epidural stimulation for spinal cord injury is still very much an experimental treatment.
Let’s go over some of its benefits and risks:
Benefits of Epidural Stimulation for Spinal Cord Injury Patients
Epidural stimulation can positively affect a lot body functions damaged by spinal cord injury.
Benefits of epidural stimulation include:
- Pain relief: Epidural stimulation can help relieve chronic pain after spinal cord injury. Whiel it won’t get rid of the source of pain, it can change the way your brain reacts to pain.
- Reversibility: If you ever decide that epidural stimulation is not for you, you can always remove the implant.
- Increased bowel, bladder, and sexual function: Electric stimulation may be able to activate spinal cord circuits that innervate the urinary tract, pelvic floor, and bowel.
- 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: With spinal cord injury recovery, every little bit of improvement is encouraging. The results yielded by epidural stimulation can cultivate a more positive mentality and improve motivation to further pursue recovery.
Now that you understand how epidural stimulation can help with spinal cord injury, let’s go over some of its risks.
Risks Associated with Epidural Stimulation for SCI
Epidural stimulation is still very much a work in progress.
Some of the setbacks of epidural stimulation include:
- 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: The average cost of treatment per patient ranges from $19,246-$47,190.
- 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.
- Discomfort: You may feel some discomfort from the stimulator itself or the electric currents it emits.
The Future for Spinal Cord Injury Recovery
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.
Until then, it’s essential that you don’t give up on recovery and keep focusing on stimulating spared pathways in your spinal cord through repetitive movement.