Advances in Epidural Spinal Cord Stimulation to Restore Function after Spinal Cord Injury: History and Systematic Review

Nadine M. Mansour, Isabela Pena Pino, David L Freeman, Kailey Carrabre, Shivani Venkatesh, David Darrow, Uzma Samadani, Ann M. Parr

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Epidural spinal cord stimulation (eSCS) has been recently recognized as a potential therapy for chronic spinal cord injury (SCI). eSCS has been shown to uncover residual pathways within the damaged spinal cord. The purpose of this review is to summarize the key findings to date regarding the use of eSCS in SCI. Searches were carried out using MEDLINE, EMBASE, and Web of Science database and reference lists of the included articles. A combination of medical subject heading terms and keywords was used to find studies investigating the use of eSCS in SCI patients to facilitate volitional movement and to restore autonomic function. The risk of bias was assessed using Risk Of Bias In Non-Randomized Studies of Interventions tool for nonrandomized studies. We were able to include 40 articles that met our eligibility criteria. The studies included a total of 184 patient experiences with incomplete or complete SCI. The majority of the studies used the Medtronic 16 paddle lead. Around half of the studies reported lead placement between T11- L1. We included studies that assessed motor (n = 28), autonomic (n = 13), and other outcomes (n = 10). The majority of the studies reported improvement in outcomes assessed. The wide range of included outcomes demonstrates the effectiveness of eSCS in treating a diverse SCI population. However, the current studies cannot definitively conclude which patients benefit the most from this intervention. Further study in this area is needed to allow improvement of the eSCS technology and allow it to be more widely available for chronic SCI patients.

Original languageEnglish (US)
Pages (from-to)1015-1029
Number of pages15
JournalJournal of neurotrauma
Volume39
Issue number15-16
DOIs
StatePublished - Aug 1 2022

Bibliographical note

Funding Information:
This study did not receive any source of funding to support the work conducted.

Publisher Copyright:
© Copyright 2022, Mary Ann Liebert, Inc.

Keywords

  • autonomic dysfunction
  • motor activity
  • spinal cord injuries
  • spinal cord stimulation

PubMed: MeSH publication types

  • Journal Article
  • Review

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