Paralysed patients able to walk following epidural stimulation

Two recent separate studies report successes with epidural electrical stimulation in helping paralysed patients regain the ability to walk.

As reported in the New England Journal of Medicine, researchers enrolled four patients who experienced spinal cord injuries roughly 3 years earlier. The patients had no motor abilities (ability to cause a predetermined movement outcome) below the level of their injuries; two of the patients retained some sensation.

Patients had an epidural stimulator implanted over spinal segments L1 to S1–S2 (at the level of loin and adjacent lower). They then underwent months of daily physical therapy with the stimulator turned on.

The two patients with sensation regained the ability to walk with assistance after 15 and 85 weeks. The other two could stand independently and perform some tasks on a treadmill but were not able to walk over ground. One patient fractured a hip during training.

Next, in Nature Medicine, researchers report outcomes in a man with complete loss of sensation and motor function below the level of the spinal cord injury. The patient had an epidural stimulator implanted below the level of injury and underwent 43 weeks of training. He regained the ability to walk about 100 meters over ground with assistance. The research team called the results "highly significant."

Patients were unable to walk when the stimulator was turned off. There have been previous trials with this treatment. But in this latest round of experiments, two of the four patients that received the implants and training actually regained the ability to walk — the first time that this treatment has made that possible.