Spinal Stimulation Gets Paralyzed Patients Moving

Video: Eliza Strickland & Celia Gorman. Footage: University of Louisville; Grgoire Courtine, Swiss Federal Institute of Technology in Lausanne Spinal stimulation:In both animal and human experiments, researchers are using electricity to restore function to paralyzed lower limbs.

Dustin Shillcox fully embraced the vast landscape of his native Wyoming. He loved snowmobiling, waterskiing, and riding four-wheelers near his hometown of Green River. But on 26 August 2010, when he was 26 years old, that active lifestyle was ripped away. While Shillcox was driving a work van back to the family store, a tire blew out, flipping the vehicle over the median and ejecting Shillcox, who wasnt wearing a seat belt. He broke his back, sternum, elbow, and four ribs, and his lungs collapsed.

Photo: Greg Ruffing Patient No. 4:Dustin Shillcox volunteered to have electrodes and a pulse generator implanted in his spine.

Through his five months of hospitalization, Shillcoxs family remained hopeful. His parents lived out of a camper theyd parked outside the Salt Lake City hospital where he was being treated so they could visit him daily. His sister, Ashley Mullaney, implored friends and family on her blog to pray for a miracle. She delighted in one of her first postaccident communications with her brother: He wrote beer on a piece of paper. But as Shillcoxs infections cleared and his bones healed, it became obvious that he was paralyzed from the chest down. He had control of his arms, but his legs were useless.

At first, going out in public in his wheelchair was difficult, Shillcox says, and getting together with friends was awkward. There was always a staircase or a restroom or a vehicle to negotiate, which required a friend to carry him. They were more than happy to help. The problem was my own self-confidence, he says.

A few months after being discharged from the hospital, in May 2011, Shillcox saw a news report announcing that researchers had for the first time enabled a paralyzed person to stand on his own. Neuroscientist Susan Harkema at the University of Louisville, in Kentucky, used electrical stimulation to awaken the mans lower spinal cord, and on the first day of the experiments he stood up, able to support all of his weight with just some minor assistance to stay balanced. The stimulation also enabled the subject, 23-year-old Rob Summers, to voluntarily move his legs in other ways. Later, he regained some control of his bladder, bowel, and sexual functions, even when the electrodes were turned off.

The breakthrough, published in The Lancet, shocked doctors who had previously tried electrically stimulating the spinal nerves of experimental animals and people with spinal-cord injuries. In decades of research, they had come nowhere near this level of success. This had never been shown beforeever, says Grgoire Courtine, who heads a lab focused on spinal-cord repair at the Swiss Federal Institute of Technology in Lausanne and was not involved with the project. Robs is a pioneer recovery. And what was surprising to me was that his was better than what weve seen in rats. It was really exciting for me to see.

Image: Susan Harkema/The Lancet/Elsevier Embedded hardware: This X-ray image of one of Susan Harkemas patients shows the electrode array implanted next to his spinal cord and the pulse generator below.

The report brought renewed hope for people living with paralysis. The prognosis is normally grim for someone like Shillcox, who has a motor complete spinal-cord injury. That level of damage usually results in a total loss of function below the injury site.

Teams of scientists have been working on transplanting stem cells for neural repair and modifying the spinal cord in other ways to encourage it to grow new neurons, but these long-term approaches remain mostly in the lab. Harkemas breakthrough, however, produced a real human success story and gives hope to paralyzed people everywhere. It presents a viable means of regaining bowel, bladder, and sexual functions, and maybejust maybepoints the way toward treatments that could give paralyzed people the ability to walk again.

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Spinal Stimulation Gets Paralyzed Patients Moving