Sunday, August 24, 2014

Why Spinal Cord Stimulation Brings Movement To Paraplegics

By Neil P. Hines

A primitive form of electrotherapy for pain relief was practice as long ago as 2700 B. C. Spinal cord stimulators were introduced thousands of years later in 1971. Be the early years of the 3rd millennium, spinal cord stimulators were being used to manage chronic pain in patients with peripheral vascular disease, refractory angina and terminal cancer. Twenty years later, scientists have reported that spinal cord stimulation brings movement to paraplegics.

For people who have been living with paralysis, this is brilliant news. It may even become possible to restore function in people years after their original injury. So far, four patients have been enabled voluntary movement in their toes, ankles and knees with the aid of these clever devices. Effects are enhanced when combined with physical rehab.

It was approximately 5,000 years ago that doctors in Egypt used torpedo fish, whose electrical properties are similar to those in the electric eel, to alleviate pain in their patients. In 47 AD, emperor Claudius of Rome, acting on the advise of his physician, applied the fish to areas of his body where he experienced pain. People suffering from gout were advised to stand on a wet beach atop a live torpedo fish .

Despite several millennia of using electricity to relieve pain, it took until 1965 to begin to understand why. That is when pain specialists Patrick Wall and Ronald Melzack proposed the gate theory of pain control. The nerves that carry the sensations of touch and vibration terminate in the same spinal cord region as those that carry painful nerve impulses. This region is the dorsal horn of the spinal cord. Melzack and Wall suggested that activating the non-painful pathways might block nerve impulses in the pain-transmitting nerves.

Studies into the application of electrical stimulation in patients with paraplegia, which began in 2009, proved more fruitful than the scientists who were involved in them with a pleasant surprise. Two of the four patients, who had total paralysis in both sensory and motor nerves, experienced restored voluntary mobility. The researchers had always assumed that at least some sensory function had to be preserved for the treatment to be successful.

Recent research was funded jointly by the Christopher & Dana Reeve Foundation and the National Institutes of Health. The Reeve Foundation exists to provide advocacy and funding for research into spinal cord injuries. Actor Christopher Reeve, who was best known for his portrayal of Superman, was paralyzed in a horseback-riding accident in 1995. He died suddenly of a heart attack in 2004. His wife, Dana, died of lung cancer in 2006, just over a week before her 45th birthday.

The National Institutes of Health is one of the world's leading centers for medical research. It consists of 27 different institutes and centers, including institutes for research into cancer, heart and lung, child health, aging and genome research among others. The NIH is mainly located in Bethesda, Maryland.

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