Injuries to the spinal cord are notoriously difficult to treat. While medical advances have led to improved outcomes, the prognosis for motor complete spinal cord injured (SCI) patients remains poor. A new study, published yesterday in Scientific Reports, details the recovery of a patient with complete spinal cord injury, who had lost motor function in his legs and has now regained the ability to voluntarily move his legs, six years after his injury.
The patient was originally treated at the Kentucky Spinal Cord Injury Research Center (KSCIRC) at the University of Louisville along with four other patients with complete spinal injury. The patients were undergoing a treatment of spinal cord epidural stimulation (scES), which delivers electrical signals to motor neurons in the spine via an implanted device, allowing patients to stand and perform voluntary lower limb movements while the device is activated.
After nine months of lab-based therapy, Andrew Meas, one of the participants in the study, completed one more year of independent training at home. This was followed by three more months of sessions in the lab after which Meas was able to voluntarily move his knees and stand without the use of scES, needing only minimal assistance to bring himself to the position and using only his hands for balance control.
While the researchers had performed scES in other participants, this was the first instance of a patient exibiting improved motor control without direct stimulation. The authors suggest several possible mechanisms for Mea’s recovery, including sprouting of axons from above the point of injury into areas below the lesion, remodeling of connections among spinal cord neurons caused by scES and the patient’s dedication to continuing efforts at home.
"It is commonly believed that one year from injury, you are classified as chronic and it's likely that you will not improve any more. This data is proof of principle that the human nervous system has much greater recovery capabilities than expected," said Enrico Recj, one of the lead authors of the study.