Liyi Hu
Background: In the USA, there are approximately 17,730 new cases of Spinal Cord Injury (SCI) each year. Recent research highlights Spinal Cord Stimulation (SCS) as a promising avenue for functional recovery in chronic SCI patients. SCS complements intensive motor training, potentially enhancing spinal circuitry, particularly in cases of incomplete SCI. We describe the case of mild gain of function as a result of SCS in the setting of incomplete cervical SCI. Case Presentation: A 60-year-old patient with a history of traumatic SCI with C5 Asia Impairment Scale (AIS) grade D presented to the clinic with chronic right upper extremity pain, numbness and spasticity. On physical exam, the patient had significant right-sided upper extremity flexor tone with limited extension of the elbow. After a review of treatment options, the patient elected to trial a SCS. The SCS 8-contact leads were placed in the cervical region covering C3-C5 and the thoracic region covering T9-T11. The trial provided a 70% reduction in the patient’s neuropathic pain, leading to permanent implantation of the neurostimulation device. At two weeks post-op, the patient reported a 100% improvement in the right upper extremity pain and an additional 60% improvement in right arm spasticity. After multiple programming adjustments, the patient regained significant function of the right elbow extensor mechanism, improving their overall function and quality of life. Conclusion: Spinal cord stimulation is a promising treatment modality that can improve spasticity and motor function after spinal cord injury.
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