PMID- 37025529
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230411
IS  - 2229-5097 (Print)
IS  - 2152-7806 (Electronic)
IS  - 2152-7806 (Linking)
VI  - 14
DP  - 2023
TI  - Spinal cord epidural stimulation for motor and autonomic function recovery after 
      chronic spinal cord injury: A case series and technical note.
PG  - 87
LID - 10.25259/SNI_1074_2022 [doi]
LID - 87
AB  - BACKGROUND: Traumatic spinal cord injury (tSCI) is a debilitating condition, 
      leading to chronic morbidity and mortality. In recent peer-reviewed studies, 
      spinal cord epidural stimulation (scES) enabled voluntary movement and return of 
      over-ground walking in a small number of patients with motor complete SCI. Using 
      the most extensive case series (n = 25) for chronic SCI, the present report 
      describes our motor and cardiovascular and functional outcomes, surgical and 
      training complication rates, quality of life (QOL) improvements, and patient 
      satisfaction results after scES. METHODS: This prospective study occurred at the 
      University of Louisville from 2009 to 2020. scES interventions began 2-3 weeks 
      after surgical implantation of the scES device. Perioperative complications were 
      recorded as well as long-term complications during training and device related 
      events. QOL outcomes and patient satisfaction were evaluated using the impairment 
      domains model and a global patient satisfaction scale, respectively. RESULTS: 
      Twenty-five patients (80% male, mean age of 30.9 +/- 9.4 years) with chronic motor 
      complete tSCI underwent scES using an epidural paddle electrode and internal 
      pulse generator. The interval from SCI to scES implantation was 5.9 +/- 3.4 years. 
      Two participants (8%) developed infections, and three additional patients 
      required washouts (12%). All participants achieved voluntary movement after 
      implantation. A total of 17 research participants (85%) reported that the 
      procedure either met (n = 9) or exceeded (n = 8) their expectations, and 100% 
      would undergo the operation again. CONCLUSION: scES in this series was safe and 
      achieved numerous benefits on motor and cardiovascular regulation and improved 
      patient-reported QOL in multiple domains, with a high degree of patient 
      satisfaction. The multiple previously unreported benefits beyond improvements in 
      motor function render scES a promising option for improving QOL after motor 
      complete SCI. Further studies may quantify these other benefits and clarify 
      scES's role in SCI patients.
CI  - Copyright: (c) 2023 Surgical Neurology International.
FAU - Boakye, Maxwell
AU  - Boakye M
AD  - Department of Neurosurgery, University of Louisville, Louisville, Kentucky.
FAU - Ball, Tyler
AU  - Ball T
AD  - Department of Neurosurgery, Vanderbilt University, Nashville.
FAU - Dietz, Nicholas
AU  - Dietz N
AD  - Department of Neurosurgery, University of Louisville, Louisville, Kentucky.
FAU - Sharma, Mayur
AU  - Sharma M
AD  - Department of Neurosurgery, University of Louisville, Louisville, Kentucky.
FAU - Angeli, Claudia
AU  - Angeli C
AD  - Department of Neurosurgery, University of Louisville, Louisville, Kentucky.
FAU - Rejc, Enrico
AU  - Rejc E
AD  - Department of Neurosurgery, University of Louisville, Louisville, Kentucky.
FAU - Kirshblum, Steven
AU  - Kirshblum S
AD  - Department of Physical Medicine Rehabilitation, Rutgers, Newark, New Jersey.
FAU - Forrest, Gail
AU  - Forrest G
AD  - Department of Physical Medicine Rehabilitation, Rutgers, Newark, New Jersey.
FAU - Arnold, Forest W
AU  - Arnold FW
AD  - Department of Infectious Diseases, University of Louisville, Louisville, United 
      States.
FAU - Harkema, Susan
AU  - Harkema S
AD  - Department of Neurosurgery, University of Louisville, Louisville, Kentucky.
LA  - eng
PT  - Journal Article
DEP - 20230317
PL  - United States
TA  - Surg Neurol Int
JT  - Surgical neurology international
JID - 101535836
PMC - PMC10070319
OTO - NOTNLM
OT  - Epidural stimulation
OT  - Functional recovery
OT  - Neuromodulation
OT  - Rehabilitation
OT  - Spinal cord injury
OT  - Spinal cord stimulation
OT  - Spinal surgery
OT  - Technical note
COIS- There are no conflicts of interest.
EDAT- 2023/04/08 06:00
MHDA- 2023/04/08 06:01
PMCR- 2023/03/17
CRDT- 2023/04/07 02:31
PHST- 2022/11/28 00:00 [received]
PHST- 2023/02/14 00:00 [accepted]
PHST- 2023/04/08 06:01 [medline]
PHST- 2023/04/07 02:31 [entrez]
PHST- 2023/04/08 06:00 [pubmed]
PHST- 2023/03/17 00:00 [pmc-release]
AID - 10.25259/SNI_1074_2022 [pii]
AID - 10.25259/SNI_1074_2022 [doi]
PST - epublish
SO  - Surg Neurol Int. 2023 Mar 17;14:87. doi: 10.25259/SNI_1074_2022. eCollection 
      2023.