How Spinal Cord Stimulation Brings Movement To Paraplegics

By Neil P. Hines


Although the treatment of pain using electricity was practiced nearly millennia before now, the spinal cord stimulator was not introduced until some time in the 1970s. By the start of the 21st century, it was used to relieve pain in people with refractory angina, peripheral vascular disease and terminal cancer. Nearly 20 years later, scientists have found that spinal cord stimulation brings movement to paraplegics.

This is welcome news to people with paralysis and may even work in people years beyond their original injury. Four people with paraplegia have been reported to gain control of movement in the ankles, knees and toes while using the ingenious devices. This effect is apparently magnified when coupled with physical rehabilitation.

Nearly five thousand years ago, physicians in Egypt were using topically applied torpedo fish, which produce powerful electrical impulse similarly to the electric eel, to relieve pain. In 47 AD, the physician to the Roman emperor Claudius, Scribonium Largus, would apply the fish to painful regions of his patient's body. Patients with gout were advised to place a living black torpedo fish under their feet while standing on a wet, sandy beach.

It was not until 1965, when pain specialists Melzack and Wall introduced the gate theory of pain control, that scientists began to understand the neural mechanisms behind the effectiveness of electrotherapy. They proposed that nerves carrying the sensations of touch and vibration and the nerves that transmit painful impulses both terminated in the same region of the spinal cord, the dorsal horn. According to this theory, by activating the non-painful sensory pathways, the "gate" could be closed to painful stimuli.

Studies into the application of electrical stimulation in patients with paraplegia, which began in 2009, proved more fruitful than the scientists who were involved in them with a pleasant surprise. Two of the four patients, who had total paralysis in both sensory and motor nerves, experienced restored voluntary mobility. The researchers had always assumed that at least some sensory function had to be preserved for the treatment to be successful.

The paralysis work was funded by both the National Institutes of Health and the Christopher & Dana Reeve Foundation. The Reeve Foundation was establish to provide patient advocacy and to fund research into spinal injuries. Christopher, famous for being Superman in a series of films, became quadriplegic as the result of a horse-riding accident and perished from a heart attack in 2004. Dana, his wife, died two years later from lung cancer.

The NIH is a consortium of 27 institutes and centers for research into cancer, aging, child health and alcoholism, among other conditions. It is located in Maryland.




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