Surgery

Spinal electrostimulation overcomes paralysis and pain.

An American with paralysis of the lower extremities was able to stand up thanks to stimulation of the spinal cord, reports MedPage Today. A new method of rehabilitation was tested by a group of researchers led by Reggie Edgerton (Reggie Edgerton) from the University of California at Los Angeles (University of California, Los Angeles). Article researchers published in the journal The Lancet.

Rob Summers sustained a spinal injury during a traffic accident in 2006. As a result of spinal cord injury at the level of the seventh cervical and first thoracic vertebrae, a 20-year-old man developed lower paraplegia - paralysis of both legs. Rehabilitation of the musculoskeletal system, which the victim underwent for 26 months, did not produce results.

According to the authors of the study, most spinal cord injuries do not lead to complete damage to this organ, and in such cases the integrity of some nerve fibers is preserved. The Edgerton group suggested that, due to the electrical stimulation, the motor neurons that survived the injury would provide the movements of the lower limbs in the victim's spinal cord.

In December 2009, a team of surgeons from the University of Louisville, Kentucky, implanted 16 electrodes into Summers' spinal cord. The electrodes were implanted into the solid membrane of the brain from the first lumbar to the first sacral vertebra and connected to an electrical impulse generator that surgeons placed in the male abdominal cavity.

Doctors conducted 29 sessions of electrostimulation of the victim's spinal cord. The duration of one session ranged from 40 minutes to four hours. As a result, Summers was able to keep his own weight on his legs for four and a half minutes. After seven months of rehabilitation, the patient was able to get up on his feet from a sitting position.

The researchers noted that Summers could only perform these exercises during spinal cord electrostimulation sessions. At other times, scientists could not register the electrical activity of the muscles of the patient's lower limbs. According to the BBC, Edgerton and his colleagues have already selected four patients for further research on a new rehabilitation method.

Electrical stimulation in the treatment of spastic paralysis 2 years, 10 months. back # 606

  • Specialist
  • Off site
  • Administrator
  • Posts: 194
  • Reputation: 3

Good afternoon, dear colleagues!

In this topic, the problem of electrostimulation in the treatment of such diseases as spastic cerebral palsy, spasms after strokes, spasms of the adductor muscles and other disorders associated with paralysis and paresis of acute genesis is suggested for discussion.
I have long been interested in this issue in terms of the possibility of using neuromodulation techniques.
Communicating with colleagues - colleagues on this topic, studying literary sources, I did not find definite answers and ready-made solutions on this topic. Collecting information on "bricks", I try to systematize this knowledge in order to create effective equipment and methods for the treatment of these diseases.

Re: Electrical stimulation in the treatment of spastic paralysis 2 years, 10 months. back # 608

  • Specialist
  • Off site
  • Administrator
  • Posts: 194
  • Reputation: 3

To start the dialogue, I propose to read the following material.

A practical example of the treatment of muscle spasticity with electric currents. In the mid-60s, in his book "Niederfrequente Ströme zur Diagnostik und Therapie" [Low-frequency currents for diagnosis and therapy] (1981, 2nd edition, Maudrich-Verlag) Dr. Jantsch and Hoefschmidt recommended a two-channel treatment of muscle spasticity, thus deriving , spasticity from the list of contraindications for electrotherapy. The fundamental principle of special electrotherapy, such as spastic cerebral palsy, spasms after strokes and spasms of the adductor muscles, is stimulation of the neuro-tendon spindles, which, in turn, is aimed at inhibiting muscle spasm at the bone marrow level. Immediately after inhibition of the affected muscle, antagonist muscles are stimulated by the second channel. In the video, Dr. Felipe Medina gives an example of adjuvant therapy.

Re: Electrical stimulation in the treatment of spastic paralysis 2 years, 10 months. back # 609

  • Specialist
  • Off site
  • Administrator
  • Posts: 194
  • Reputation: 3

Here is another interesting source

SPASTIC PARALICH
Belova A.N. Neurorehabilitation: A guide for doctors. - M., 2000. Chapter 4
Principles of restorative treatment for major neurological disorders.
dromah. 4.1. Spastic paralysis.

Electrical stimulation was first used to treat spastic paralysis.
as far back as Duchene in 1871. Since then, in the treatment of muscle hypertonus,
location, subcutaneous, epidural arrangement of the electrodes, as well as their peroneal implantation
tation.
Peripheral nerve electrical stimulation is traditionally used in patients with lower
spastic paraplegia when standing, walking, doing physical exercises. Doka-
efficiency of surface electrostimulation in patients with post-stroke spasi-
hemiplegia [Fakhri O. et al., 1994]. In patients with spinal cord lesions for
reduce the tone attempts are made to use the electrical stimulation of the spinal cord (back
these are pillars) by the epidural introduction of electrodes [Gottlieb G., 1985]. The mechanism of influence
stimulation of increased muscle tone is associated with neurotransmitter
modulation at segmental level. Decreased muscle tone is usually temporary,
observed within a few hours after the procedure. Modes of influence
like the parameters of the electrostimulating current depend on the etiology and localization of
ralicha.
Electrical stimulation of muscles during spastic paralysis is carried out mainly with
With the creation of focused intense afferention from stimulated muscles,
contributes to the disinhibition of temporarily inactivated nerve elements near
focus of destruction, and also helps in training new motor skills, improves
trophic muscle tissue. In spastic paralysis, antago stimulation is recommended.
spastic muscles, since “electro-gymnastics” of hypertonic muscles can be
call for an additional increase in muscle tone. Most often, the stimulation is carried out
Kami higher frequencies, because the low-frequency currents, possessing significant distress
stinging effect on the skin, causing pain, which may also contribute
Vovat hypertonus enhancement. When using the apparatus "Amplipulse" used II kind
works at the mode "package-pause", frequency 50-100 Hz and modulation depth 75-100%. Length
A series of oscillations is set to 2 seconds, and the duration of pauses is 5 seconds. Continued
The intensity of stimulation of each muscle group gradually increases from 5 to 20 minutes,
The treatment consists of 18-30 procedures [Tkacheva G.R. et al., 1975].
In the treatment of spastic paralysis, there may also be
reinforced and modified biopotentials of healthy muscle groups were used,
moreover, biostimulation can be multichannel. Among the multichannel devices
bioelectrically controlled stimulation is most widely used
"Mioton", developed at the Kiev Institute of Cybernetics. Operating principle
Each channel of this device is that enhanced and integrated biopoceae
donor potentials, taken from a specific muscle group and performing the role of "algorithm-
ma "movement, control signals from the generator of alternating high-frequency currents,
given to a specific muscle group of the recipient. Record signals from the donor to
The tape recorder allows you to repeat a given program of movement.

When electromyostimulation of the spinal cord is used

Electromyostimulation comes to the aid of chronic pain syndrome, because steroid injections can not be used for a long time, because they can cause considerable damage:

  • violation of the gastrointestinal tract,
  • development of bone resorption,
  • endocrine disorders, etc.

In 70% of cases, electrostimulation helped to relieve pain medication.

Indications for electrostimulation are:

  • posttraumatic dystrophy,
  • peripheral nerve damage
  • spinal arachnoiditis,
  • ischemic paralysis
  • cerebral palsy, including cerebral palsy (cerebral palsy),
  • para- and tetraparesis for dorsal herniation of the intervertebral disc,
  • somatic disorders of neurological nature,
  • phantom pains
  • chronic radicular syndrome, etc.

Trial electrostimulation

  • At the first stage, using an epiduroscopy method under local anesthesia, electrodes are inserted into the epidural space of the spinal cord.
  • Visual observation with the endoscope video camera allows you to arrange them as accurately as possible.
  • A trial test is conducted: for a certain time, the pain dynamics is analyzed - whether or not there is no reduction of pain under the influence of impulses.
  • Experimentally determine the most optimal radiation parameters.

Contraindications for electromyostimulation

Complications with this procedure, if the system is introduced correctly, are relatively rare, but still the patient after the introduction of the endoscope may have not very pleasant feelings:

  • feeling of pressure at the location of the endoscope,
  • pain, paresthesia,
  • clouding of consciousness for two or three minutes.

The nature of the possible complications:

  • damage to the dura mater, nerve roots,
  • infectious inflammatory processes and bleeding.

It is also possible allergies to drugs with side effects:

  • reactive adhesions,
  • numbness of the limbs
  • pelvic dysfunction.

Clinical practice cases

The effectiveness of electrical stimulation is proven by joint research of Russian and American scientists.

In 2014, they investigated the effect of electrical stimulation on four men who had a terrible accident, which led to loss of sensitivity and impaired motor functions of the legs.

In the lumbosacral region of the epidural space of the spinal cord, in the area containing the large venous plexuses, they were implanted with electrodes imitating signals from the brain to motor neurons.

Patients soon had a very positive dynamic:

  • restored motor functions of the legs,
  • work of intestines and urinogenital system was adjusted,
  • the muscular system has got stronger,
  • improved health.

Electrical stimulation in the treatment of cerebral palsy

Electromyostimulation with cerebral palsy is effective in spastic paraparesis of the lower extremities, while the endoscope is inserted into the lumbar thickening.

Constant electrical stimulation for cerebral palsy is often practiced abroad in patients with:

  • with spinal spastic paralysis,
  • with multiple sclerosis,
  • with severe post-traumatic consequences.


As a result of research of our scientists it was found out:

  • The use of electrostimulation of the lumbar spine in patients with cerebral palsy reduced muscle spasms of not only the lower but also the upper limbs.
  • As a result of the ensuing normalization of muscle tone, SCS stimulation could be stopped one or two years after the operation.

Cerebral palsy is treated very long and difficult. In treatment, in addition to electrical stimulation, neuromuscular blockades, neurosurgical operations, and physiotherapy methods are used.

But about this - in a separate article.

Video: How to distinguish paresis from paralysis

Watch the video: Researchers Strive to Help Paralyzed Man Make Strides - Mayo Clinic (January 2020).

Loading...