Long-term functional recovery and immediate neuromuscular facilitation following epidural spinal cord stimulation in chronic spinal cord injury: a pilot cohort study.
All spinal cord injury patients exceeded meaningful improvement thresholds after epidural spinal cord stimulation
Long-term functional recovery and immediate neuromuscular facilitation following epidural spinal cord stimulation in chronic spinal cord injury: a pilot cohort study.
Epidural spinal cord stimulation (eSCS) has shown promise in facilitating motor recovery in chronic spinal cord injury (spinal cord injury); however, long-term functional trajectories beyond 12 months and the neurophysiological mechanisms underlying eSCS-mediated recovery remain poorly characterized.
This pilot cohort study investigated the 24-month functional recovery trajectory following eSCS combined with structured rehabilitation in patients with chronic spinal cord injury and evaluated the immediate neuromuscular facilitation effects of eSCS using surface electromyography.
Eleven patients with chronic spinal cord injury (median age, 56 years; 90.9% male; AIS grades A-D; median time since injury, 7 years) who underwent eSCS implantation and completed at least 24 months of follow-up were included.
every patient improved enough to matter clinically, not one fell short
Significant improvements were observed across all functional domains over 24 months.
Median motor score increased from 60 to 66 (Δ = +6.0, p = 0.001), Barthel Index from 40 to 60 (Δ = +20.0, p = 0.001), and WISCI II from 5 to 13 (Δ = +8.0, p = 0.001).
VAS decreased from 6 to 3 (Δ = -3.0, p = 0.002), and WHOQOL-BREF increased from 39 to 53 (Δ = +14.0, p = 0.001).
In patients with chronic spinal cord injury, eSCS combined with structured rehabilitation produced sustained and clinically meaningful improvements across multiple functional domains over 24 months, with recovery continuing beyond the first year.
These findings support eSCS as a long-term therapeutic strategy for chronic spinal cord injury and highlight the importance of extended follow-up to capture the full recovery trajectory.