Spinal Cord Electrical Stimulation + Exoskeleton Robot: Restoring the Hope of Walking for Paraplegic Patients
Source: China.org.cn
In June 2024, Mr. Li, a spinal cord injury patient from Sichuan Province, came to the Neurosurgery Department of the Seventh Medical Center of the General Hospital of the People's Liberation Army after much inquiry and consultation, seeking treatment from Director Xia Xiaoyu's team. Nine months ago, Mr. Li fell during a mountain climbing trip and suffered from hematoma both inside and outside the dura mater at the C6-C7 level of the cervical spine and spinal cord injury. After multiple surgical treatments, the motor function of his upper limbs recovered to some extent, but there were still abnormal and absent sensations in the segments below the anterior superior iliac spine, his lower limbs were unable to move independently, and he had urinary and fecal dysfunction. Mr. Li has been insisting on rehabilitation therapy, but the functional recovery has not been breakthrough, and the spasticity of his lower limbs has become increasingly severe, thereby restricting the implementation of many rehabilitation exercises, and the treatment has been at a standstill.
After detailed preoperative examinations and evaluations upon admission, Director Xia Xiaoyu and Director Li Wende performed spinal cord electrical stimulation implantation for the patient. Guided by electrophysiological monitoring, the electrode was accurately implanted into the target segment. Due to the small surgical trauma, the patient did not have any surgery-related reactions such as fever after the operation, and the recovery was very smooth.
The electrical stimulation was initiated for the patient on the third day after the operation. Under the stimulation of microcurrent, the patient's flexed and tense lower limbs relaxed, and the spasticity and increased muscle tone were rapidly and effectively alleviated. The initial programming effect was very satisfactory, and the patient and his family finally showed relaxed and hopeful smiles.
After the initial test, the team set three sets of stimulation parameters for Mr. Li's specific symptoms. The first set was aimed at relieving the spasticity of the patient's lower limbs to facilitate the implementation of subsequent rehabilitation projects. The second set was aimed at restoring motor function. 5Hz stimulation caused tremors in the lower limb muscles, curbing the trend of muscle atrophy, and expecting to enhance the patient's muscle strength and improve motor function after long-term stimulation. The third set was aimed at improving bladder function and defecation function. The first set of stimulation parameters was mainly used in the initial stage, and subsequent adjustments were made according to the patient's specific situation. One week after the operation, under the suggestion and guidance of Director Li Wende, the patient experienced walking training assisted by the exoskeleton rehabilitation robot. Although it was only a walking movement made by passive traction and not normal walking, the patient was very excited. Recalling the state when he first came to the hospital: he could only be in a wheelchair and could not imagine standing and walking at all. The treatment in less than a month has opened up a new picture for the patient...
Director Xia Xiaoyu pointed out that the treatment of sequelae of spinal cord injury is very difficult and is a medical problem. Traditional surgical treatment is almost powerless in the rehabilitation stage except for early decompression and internal fixation. At present, there have been many advancements due to the introduction of new technologies. Spinal epidural electrical stimulation is already on the path to success. We do not need and it is currently impossible to completely cure spinal cord injury, but partial repair and thus restoration of some functions are currently possible. The new functional neurosurgery technologies represented by spinal cord electrical stimulation neuromodulation, combined with the new rehabilitation technologies represented by exoskeleton robots, have made it no longer an unreachable dream for patients to regain the ability to walk!
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