At San Raffaele neurostimulator implant helps young woman to walk again

It bears the signature of the team of neurosurgeons of the IRCCS San Raffaele Hospital (San Donato Group), led by Pietro Mortini, Full Professor of Neurosurgery at UniSR and head of neurosurgery: the innovative surgery enabled a young woman with lower limb paralysis to recover motor functions through the implantation of a spinal cord neurostimulator.

The young woman, 32, a victim of a sports accident that caused her spinal cord injury, is now able to maintain standing and walk with the aid of a walker.

The achievement was made possible through collaboration with a group of engineers from the Institute of Biorobotics Institute of the Scuola Superiore Sant'Anna in Pisa, headed by internationally renowned expert Professor Silvestro Micera, Professor of Bioelectronics and Neural Engineering.

The patient is still performing with excellent results a complex rehabilitation process defined by Dr. Sandro Iannaccone, head of the Cognitive-Motor Neurological Disorders Rehabilitation Unit.

Professor Mortini explains:

"We are conducting an advanced clinical research protocol, coordinated by my collaborator Dr. Luigi Albano, at the end of which this intervention could enter current clinical practice, offering a therapeutic solution to patients with spinal cord injuries."

"The next step," clarifies Professor Mortini, "will be to also treat spinal cord injuries caused by neurodegenerative diseases, such as multiple sclerosis, in patients who will be recruited by the Neurology Unit of IRCCS San Raffaele Hospital, directed by Professor Massimo Filippi".

This protocol is part of an advanced research program that UniSR and IRCCS Ospedale San Raffaele have activated to develop innovative therapies that make use of an interface between electronic devices and the central nervous system to vicariate its functional deficiencies.

The implanted device consists of two parts:

• a biocompatible holder for 32 electrodes that is inserted into the epidural space of the spine;
• a pulse generator, (a kind of pacemaker) similar to those used in patients with cardiac arrhythmias, inserted under the skin at the hip level. The impulses are delivered to the spinal cord from where they then transit to the nerves and muscles.

The device was implanted in about 3 hours through a delicate, minimally invasive neurosurgical procedure performed under continuous neurophysiological monitoring. The pacemaker was then programmed to ensure coordinated activation of all muscles necessary for walking.
Control of pacemaker function is possible through a range of functional options that can be chosen by the patient based on the locomotor needs of daily life.

Photo credit cover image: Alessandro Gandolfi/ParalleloZero