Case Study: Epidural Electrical Stimulation After Spinal Cord Injury

In a paraplegic young man, electrical stimulation over the low spinal cord elicited low-level electromyographic activity synchronized to the manually controlled stepping cycle and modest voluntary flexion in one leg while supine.

A 23-year-old athlete who had been struck by a motor vehicle lost all voluntary lower-extremity movement as a result of a chronic C7–T1 subluxation injury. Sensation was present below T1. After 170 sessions of treadmill training with partial body-weight support and fully manually controlled stepping failed to elicit electromyographic (EMG) activity in the leg muscles, a 16 electrode array stimulator was implanted on the dorsal dura over L1–S1.

After additional attempts to stand and step on the treadmill with weight support on the treadmill, the man was able to stand with clonic leg movements for up to a few minutes while holding on to a bar for balance and while the stimulator was on, before his legs gave way to fatigue. Low-amplitude bursts…

Reviewing Author

Bruce H. Dobkin, MD