Implant Helps People With Paralysis Regain Use Of Limbs

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For the past five years, Brian Gomez hasn’t been able to move his arms or legs.

That’s slowly changing for Gomez, who is a quadriplegic, thanks to surgeons at the Ronald Reagan UCLA Medical Center.

There, medical officials are developing a stimulation device that can be implanted near the top of the spine of a person with paralysis.

The stimulator bypasses an injured region so it can navigate along different pathways to send brain signals to a person’s hands. This allows them to move those limbs.

Researchers report as much as a 300 percent increase in grip strength and finger motion in the three people who have received the surgery so far.

“There are few effective treatments for patients with spinal cord injury. This is one of the first effective strategies that can restore lost function to the patient. This indeed is a major breakthrough,” Dr. Daniel Lu, a neurosurgeon at the UCLA facility, and the first surgeon to implant the stimulator, told Healthline.

The greatest benefit, he adds, is perhaps the freedom this limited movement provides people with paralysis.

“With the increased strength, the patient is able to perform tasks involved in activities of daily living, such as dressing, using a smart phone, typing on a keyboard, self-care, and transfer, essentially becoming more independent,” Lu said.

So is the case for Gomez, one of the people who has benefitted from this surgery.

In 2011, Gomez became a quadriplegic after a mechanical failure in his dirt bike caused him to crash.

He dislocated his hips and damaged his fifth cervical vertebra (C5), the section of the spine directly beneath the skull.

After his accident, Gomez was wheelchair-bound.

“I decided to partake in this study and have the surgery this year because the likelihood of risks occurring were very low,” Gomez told Healthline. “Of course, I want to get the best out of this for myself, but my success can also help out a lot of other people. After my accident, I made many friends who are also in wheelchairs. So it’s like being able to help myself and my friends at the same time.”

Gomez underwent the three-hour outpatient operation in June. He didn’t experience any complications.

No robots needed

The technology is unique from others that use robotic limbs. The stimulator utilizes the patient’s arms and legs without robots or exoskeletons.

The device can be turned on and off. The frequencies of stimulation can also be adjusted using a battery pack and remote control.

When the device is on, Gomez says there is some discomfort and the stimulation feels similar to electrical muscle stimulation that many people have after surgery for injuries like a knee ligament tear.

“At first, the stimulation needed to be really high for me to get a response, which was pretty uncomfortable, but as we’ve progressed, adjusted the stimulation and configurations on the device, we’re able to use less stimulation to get the same results. I can still feel it, but it no longer hurts,” he said.

But how exactly does the device work?

Gomez says to think of it like a television’s relationship to a remote control.

“Your remote is not hooked up to the TV, but you can turn it on and switch the channels anytime you want with the controller. So [the doctors are] programming the device that’s inside of me, and trying to determine the best settings for me,” he said.

Once the parameters are set, Gomez says he will be able to turn the device on and off while at home. Right now, this can only be done when he is at UCLA under supervision.

With the device on, Gomez says he sees improvements in his abilities to open and close his hands, reach out and grab an item, and bend over and grab something off the floor without having to hold onto the wheelchair to pull himself back up.

“I just had an unexpected thing happen,” he said. “Before I could feel the stimulation in my legs but I couldn’t do anything with it, but yesterday for the first time my legs started moving with the stimulation on. I’ve been thinking all along that I’m grateful for improvements in my arms, and when that happened with my legs, it was amazing.”

In fact, Lu said UCLA has already pioneered stimulators in an experimental setting for use on lower limbs.

“The lower limbs function by a central pattern generator [CPG] function, meaning that there is an automatic, rhythmic property of the circuit related to walking. The stimulators at the lumbosacral spinal cord appear to tap into this CPG property. The unique observation with the cervical stimulator in our subjects is that there appears to also be CPG properties in the cervical spine related to upper extremity movement, which is a novel scientific observation,” Lu explained.

Residual benefits

Gomez also experiences improvements when the device is off.

“I’m definitely stronger as a whole. My ability to do daily activities, such as shower and go to the bathroom have become easier,” he said.

Moving around in his wheelchair is easier too.

“Every sidewalk is tilted toward the street for the rain to drain. This means my wheelchair leans that way,” he said. “Now, I can push with that other arm harder to stay straight. My improved balance and strength also makes going up hills and driveways much faster.”

Gomez’s success is encouraging for the possibilities of the technology, says Lu.

“This is an exciting experimental study and we are finding out more about the ability to neuromodulate or alter the function of the spinal cord in the injured setting through electrical stimulation,” Lu said. “We believe that this technology can positively impact the lives of those with spinal cord injury with even potentials outside of spinal cord injury such as stroke or traumatic brain injury. We are excited about the possibilities.”

By Cathy Cassata

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