Abstract
Objective
To report on unexpected findings in 4 patients with chronic paraplegia who underwent
the laparoscopic implantation of neuroprosthesis procedure in the pelvic lumbosacral
nerves.
Design
Observational case series.
Setting
Tertiary referral unit specialized in advanced gynecological surgery and neuropelveology.
Participants
Three patients with incomplete American Spinal Injury Association (ASIA) Impairment
Scale (AIS) grade B (n=2) and AIS grade C (n=1) spinal cord injury (SCI) and 1 patient
with flaccid complete chronic SCI (AIS grade A) (n=1).
Intervention
Functional electrical stimulation (FES)-assisted locomotor training and continuous
low-frequency pelvic-lumbosacral neuromodulation.
Main Outcome Measures
Change in ASIA Lower Extremity Motor Scores, ASIA sensory scores for light touch and
pinprick sensation, and Walking Index for Spinal Cord Injury scores.
Results
All 4 patients developed progressive recovery of some sensory and voluntary motor
functions below the lesions. Three are currently capable of voluntary weight-bearing
standing and walking a few meters with a walker without FES. The first patient with
the longest follow-up is even capable of electrically assisted standing/walking with
2 crutches without braces or assistance for a distance of about 900 meters, and of
weight-bearing standing and walking for 30 meters with a walker without stimulation.
Conclusions
We report unexpected sensory and locomotor recovery in 4 people with paraplegia with
SCI. Our findings suggest that FES-assisted locomotor training with continuous low-frequency
pelvic nerve stimulation in patients with SCI may induce changes that affect the central
pattern generator and allow supra- and infraspinal inputs to engage residual spinal
pathways.
Keywords
List of abbreviations:
AIS (American Spinal Injury Association Impairment Scale), FES (functional electrical stimulation), SCI (spinal cord injury)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 21, 2013
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.