Paralysed men walk again thanks to spine implant

New technology mimics the way the spinal cord is activated by the brain

Three patients suffering from complete paralysis had their body movements rapidly restored thanks to a new implant being studied as part of an ongoing clinical trial.

The novel implant electrically stimulates the spinal cord and was found to restore body movements within a few hours of the onset of therapy in the patients, showed new research.

The implant stimulated muscles with electrical impulses, mimicking the brain’s actions, and could potentially lead to novel therapies for people with severe spinal injuries who struggle to stand, walk and exercise.

Personalised implants that can stimulate specific regions inside the bodies of patients can allow them diverse body movements despite the most severe spinal cord injuries, showed the findings described in the journal Nature Medicine on Monday.

While electrical stimulation of the spinal cord has been a promising treatment option for restoring body movements in people with spinal cord injuries, these approaches have so far primarily involved repurposing technologies originally designed to treat pain, researchers said.

The scientists, including Andreas Rowald from the Swiss Federal Institute of Technology (EPFL), said these re-purposed electrical stimulation devices failed to stimulate all the nerves in the spinal cord associated with leg and trunk movements.

The use of such neuro-technologies limited the recovery of all motor functions as a result, the scientists added.

In the new research, the scientists designed a new electrode paddle that targeted all the nerves associated with leg and trunk movements in the spinal cord.

“So we’ve developed a completely new electrode array that is wider and longer. I could implant this electrode array just under the vertebra and upon the spinal cord,” Jocelyne Bloch, the study’s corresponding author from EPFL, said in a statement.

“With the technology we can access a broader region of the spinal cord in order to not only activate the leg muscles but also the trunk muscles,” Dr Bloch said.

They personalised the use of this new technology for each patient using a computerised analysis that helped researchers precisely position the device’s electrode paddles for each person and customise their activity-dependent stimulation programmes.

“We also developed software supporting the rapid configuration of activity-specific stimulation programmes that reproduced the natural activation of motor neurons underlying each activity,” the scientists wrote in the study.

“We have a mini-computer that the patients can carry with them and that delivers the stimulation and adjusts and synchronises them with the ongoing movement,” Gregoire Courtine, another co-author of the study from EPFL, explained, adding that the new technology mimicked the way the spinal cord is activated by the brain.

Using this optimised approach, the scientists showed they could rapidly restore independent walking and other motor activities, such as cycling and swimming in a single day.

The study involved using this approach in the three patients – all men between 29 and 41 years of age – who suffered complete paralysis of body movement.

With further rehabilitation, the patients could also conduct these activities within their communities, the study noted.

Scientists believe this ongoing clinical trial underscored the superior effectiveness of purpose-built, personalised spinal cord-stimulation approaches.

While the researchers said significant work was needed before the implant could be made available outside of clinical trials, they said the approach offered promise in providing meaningful improvements in people with a broad range of spinal cord injury severities.