"I Felt the Ball"-The Future of Spine Injury Recovery

World Neurosurg. 2020 Aug:140:602-613. doi: 10.1016/j.wneu.2020.05.131. Epub 2020 May 21.

Abstract

Spinal cord injury (SCI) has no cure and individuals with SCI become dependent on others for life. After injury, the signals below the lesion are disrupted, but the brain still produces motor commands. Researchers have bypassed this obstacle, which has given rise to the brain-machine interface (BMI). BMI devices are implanted in the brain or spinal cord, where they decode and send signals beyond the injured segment. Experiments were initially conducted on animals, with favorable results. BMIs are classified according to their type, function, signal generation, and so on. Because of invasiveness, their long-term use is questionable, because of infections and complications. The use of an implantable epidural array in patients with chronic SCI showed that participants were able to walk with the help of a stimulator, and after months of training, they were able to walk with the stimulator turned off. Another innovation is a robotic suit for paraplegics and tetraplegics that supports the movement of limbs. The research on stem cells has not shown favorable results. In future, one of these cutting-edge technologies will prevail over the other, but BMI seems to have the upper hand. The future of BMI with fusion of robotics and artificial intelligence is promising for patients with chronic SCI. These modern devices need to be less invasive, biocompatible, easily programmable, portable, and cost-effective. After these hurdles are overcome, the devices may become the mainstay of potential rehabilitation therapy for partial recovery. The time may come when all patients with severe SCI are told "You will walk again."

Keywords: Brain–machine interface; Epidural electric stimulator; Exoskeleton; Paraplegic walking; Robotic limb; Robotic suit.

Publication types

  • Historical Article

MeSH terms

  • Brain-Computer Interfaces* / history
  • Exoskeleton Device*
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Neurological Rehabilitation
  • Paraplegia / etiology
  • Paraplegia / rehabilitation*
  • Quadriplegia / etiology
  • Quadriplegia / rehabilitation*
  • Recovery of Function
  • Spinal Cord Injuries / complications
  • Spinal Cord Injuries / physiopathology
  • Spinal Cord Injuries / rehabilitation*
  • Spinal Cord Stimulation*