Options for the use of epidural stimulation in individuals with motor complete spinal cord injury
Authors:
V. Rybka; J. Kříž
Authors‘ workplace:
2. LF UK a FN Motol, Praha
; Spinální jednotka, Klinika rehabilitace, a tělovýchovného lékařství
Published in:
Cesk Slov Neurol N 2025; 88(1): 9-14
Category:
Review Article
doi:
https://doi.org/10.48095/cccsnn20259
Overview
Spinal cord injury is associated not only with sensory and motor impairment below the level of the lesion, but also with other complications such as autonomic nervous system dysfunction, spasticity, or neuropathic pain. While intensive rehabilitation can alleviate neurological deficits in incomplete spinal cord lesions, the neurological picture in clinically complete lesions remains fundamentally unchanged. In recent years, the potential of epidural spinal cord stimulation has been investigated, showing promise as a method capable of partially restoring lost function even in complete spinal cord lesions. This review outlines the development of the method, from pain modulation to the restoration of voluntary movement using a digital bridge between the motor cortex and spinal cord stimulator. Over the past twenty years, significant progress has been made from slight improvement in mobility in incomplete lesions to the restoration of standing and walking in motor complete injuries. The work also includes a summary of the effects on autonomic functions, with impacts on the cardiovascular system, bladder control, and sexual functions. The limitations of these studies are primarily the heterogeneity of program settings, small patient cohorts, and the risks associated with stimulator implantation. Nevertheless, epidural spinal cord stimulation represents a significant advance in the treatment of spinal cord injury, with a positive impact on the quality of life for this population.
Keywords:
autonomic nervous system – spinal cord injury – Paraplegia – neuromodulation – epidural spinal cord stimulation
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Paediatric neurology Neurosurgery NeurologyArticle was published in
Czech and Slovak Neurology and Neurosurgery
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