A Review of Functional Restoration From Spinal Cord Stimulation in Patients With Spinal Cord Injury

Neurospine, 2022 · DOI: https://doi.org/10.14245/ns.2244652.326 · Published: September 9, 2022

Simple Explanation

Spinal cord injury (SCI) often leads to loss of sensory, motor, and autonomic function below the level of injury. Recent advancements in spinal cord electrical stimulation (SCS) for spinal cord injury have provided potential avenues for restoration of neurologic function in affected patients. This review assesses the efficacy of spinal cord stimulation, both epidural (eSCS) and transcutaneous (tSCS), on the return of function in individuals with chronic spinal cord injury.

Study Duration

Not specified

Participants

327 patients with spinal cord injury

Evidence Level

Review Article

Key Findings

1
One hundred eight of 127 patients saw improvement in sensorimotor function, 51 of 70 patients saw improvement in autonomic genitourinary function, 32 of 32 patients saw improvement in autonomic pulmonary function, and 32 of 36 patients saw improvement in autonomic cardiovascular function.
2
Although this review highlights SCS as a promising therapeutic neuromodulatory technique to improve rehabilitation in patients with SCI, further mechanistic studies and stimulus parameter optimization are necessary before clinical translation.
3
This review indicates that eSCS and tSCS are efficacious and safe treatments for chronic SCI, with the potential to improve motor and autonomic function following SCI

Research Summary

This review aims to assess the efficacy of spinal cord stimulation, both epidural (eSCS) and transcutaneous (tSCS), on the return of function in individuals with chronic spinal cord injury. The current literature on human clinical eSCS and tSCS for spinal cord injury was reviewed. Although this review highlights SCS as a promising therapeutic neuromodulatory technique to improve rehabilitation in patients with SCI, further mechanistic studies and stimulus parameter optimization are necessary before clinical translation.

Practical Implications

Improved Motor Function

SCS, particularly eSCS and tSCS, shows potential for restoring motor function in SCI patients, offering a chance to regain volitional movement and muscle strength.

Autonomic Function Restoration

SCS can improve autonomic functions like bladder control, pulmonary function, and cardiovascular stability, enhancing the overall quality of life for individuals with SCI.

Personalized Stimulation Parameters

Optimal outcomes require individualized stimulation parameters, tailored to specific functions and patient needs, necessitating further research to refine these settings for clinical use.

Study Limitations

1
The need for further mechanistic studies to define optimal stimulation parameters.
2
The lack of standardization in stimulation frequency and location to elicit specific outcomes.
3
The bias in the reviewed studies towards a predominantly male patient population.

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