Also, it brought medical help and diagnosis closer to people such that devices such as smart wristwatches and other medical applications can monitor, collect patients’ data and alert individuals to necessary events.
Recently, after three decades of preclinical and clinical trials, a team of medical researchers has invented a revolutionary spinal cord implant that would allow paraplegics to walk, swim and cycle again.
The implant, as described by DailyMail, referred to as Epidural Electrical Stimulation, targeted the dorsal roots (the sensory root of a spinal nerve responsible for carrying information to the spinal cord) of lumbosacral segments and restored walking in people with spinal cord injury.
Paraplegics are persons suffering from paraplegia also called leg paralysis, who are unable to voluntarily move the lower parts of the body.
Spinal cord experts at Spinalcord.com, defined paraplegia, sometimes called partial paralysis, as a form of paralysis that impedes functioning from below the level of the injury. They added that the main cause of the problem resided in the brain or spinal cord inhibiting the ability to send or receive signals to the lower body due to the injury or disease.
The implant, according to a journal by Nature Medicine, was worked on by a team of 69 medical experts. The journal noted, “Epidural Electrical Stimulation is delivered with multielectrode paddle leads that were originally designed to target the dorsal column of the spinal cord. Here, we hypothesised that an arrangement of electrodes targeting the ensemble of dorsal roots involved in leg and trunk movements would result in superior efficacy, restoring more diverse motor activities after the most severe SCI. To test this hypothesis, we established a computational framework that informed the optimal arrangement of electrodes on a new paddle lead and guided its neurosurgical positioning. We also developed software supporting the rapid configuration of activity-specific stimulation programs that reproduced the natural activation of motor neurons underlying each activity.”
The researchers, however, stated that the device, while providing SCI patients with the opportunity to, over time, walk, swim and cycle was not a cure for SCI, emphasising the need for extensive training for patients to “get comfortable with the specific stimulation programmes for each type of movement.”
One of the three patients that tested the implant, a 29-year-old Italian, Michel Roccati, had lost the use of his legs four years ago, after a motorbike crash and had been confined to a wheelchair.
He was quoted as saying, “The first few steps were incredible, a dream come true. I’ve been through some pretty intense training in the past few months and I’ve set myself a series of goals. For instance, I can now go up and down stairs and I hope to be able to walk one kilometre (0.62 miles) by this spring.”
DailyMail reported that aside from EES, some scientists from Tel Aviv University invented a 3D spinal cord implant through the engineering of stem cells that would make paraplegics walk again. The research, which was carried out in paralysed mice, reprogrammed fat cells from humans and recorded an “80 per cent success rate in restoring the rodents’ ability to walk.” However, the researchers are hopeful for a successful clinical trial of the implant in humans.
Data from America’s National Spinal Cord Injury Statistical Centre revealed that about 294,000 people live with spinal cord injury and about 17,810 people have new spinal injuries every year.
Vehicle accidents, 39 per cent, was pegged as the highest cause of the injury while falls, 32 per cent, violence, 14 per cent, sports, 7.8 per cent, medical/surgical, four per cent and others 3 per cent were common causes of the injury.
Meanwhile, in the United Kingdom, about 50,000 people live with SCI and about 500,000 people globally are affected.
Research conducted by a team of health professionals on the prevalence and outcome of care among patients with spinal cord injury at the University College Hospital, Ibadan, Oyo State, revealed that of the 850 patients admitted into the ward for neurosurgery, cardiothoracic, haematology and oncology patients from 2015 – 2018, 132 cases were of SCI with a prevalence rate of 15.5 per cent.
It further noted that motor vehicle road accidents accounted for 43.9 per cent of the cases while 8.3 per cent were passenger road traffic accidents and 18.9 per cent were caused by degenerative spine disease.
Furthermore, a comparison of various studies from the southern and western parts of Nigeria revealed a yearly increase in SCI cases with physical trauma as the major cause of the injury.
Commenting on the innovation, a Professor of Orthopaedics and Traumatology, Faculty of Clinical Sciences, College of Medicine, Ambrose Alli University, Ekpoma, Edo State, John Onuminya, said that the invention and awareness of the medical technology was a ray of hope to paraplegics.
He added that though Nigeria might be late to be at par with the developed nations in taking advantage of the AI-powered invention, the awareness of such medical intervention would give those with the wherewithal access to such care.
Onuminya said, “As for the application of artificial intelligence in medicine and spinal injured patients, one of the hopes for Nigeria is the awareness that there is an intervention in the making. It is just like discussing the use of stem cells in the regeneration of the spinal cord, though the wherewithal is not with us and the actual practice is far from us but that we hear of it is a ray of hope for all of us.
“Though the government is not positioned to provide such aggregate readymade in Nigeria, this awareness provides a ray of hope for paraplegics in the country that something can be done to change their state. If it (the implant) is actualised and it is practical, proven and reliable, I would like to insinuate that there would be some Nigerians that would afford it and begin to access the facility.”
The expert added, “However, it is too early to be jubilant; we hear of short-term results, we also want to wait to see the long-term result. Is it sustainable or is it just a short-term thing? I think, whichever way it goes, that people are thinking and working in that area gives us a lot of hope in the management of paraplegics. We will join the rest of the world to pray that the breakthrough would be sustained and real for the world. We will key to it, we may not be there immediately but we will have a government that wants to invest in this technology. I am also waiting for a time when the initiative would start from Nigeria.”
He noted that the best intervention for paraplegics was prevention, stating that the commonest cause of SCI was road traffic accidents and falls from palm trees.
He advised that early presentation of spinal cord injury patients to hospitals would aid recovery of the spine and prevent further complications.
He decried the lack of funding for the care of those suffering spinal cord injuries and the limited number of skilled hands and facilities, noting that the development caused a delay in remedying those whose spinal cord could still be treated.
On his part, a Professor of Physiotherapy at the Faculty of Allied Health Sciences, Bayero University, Kano, Oluwaleke Sokunbi, said that the feasibility of the implant depended on the functioning of other parts of the body, adding that a good amount of strength in the trunk and upper extremities of paraplegics was important.
Sokunbi said, “The feasibility of this working would depend on three major factors, which are one; the level at which the spinal cord is affected, the lower the level of spinal cord affectation, the higher the likelihood that the implant might work. Second, it would depend on the strength of other parts of the body needed for mobility and unaffected by paraplegia. And that would include limb muscle strength and coordination and trunk muscle strength and coordination. The third major factor is the integrity of the central nervous system. If the central nervous system is intact and functioning well, especially the brain, the more the likelihood that the implant would work. Mobility also depends on the functioning of other sense organs. You can’t rule out the contribution of the eyes, ear; that is for balance when walking, and other sense organs.”
The spinal rehabilitation specialist added that there was a need for a conducive environment that would aid the appropriate movement and activities of paraplegics with the implant.
He added, “It is worth trying and I look forward to reading the result of such trials. Anything that would make the further integration of these people into normal society is worth trying. It is not just a ray of hope but a bright light of hope.’’
Also, a professor of neurology in one of the nation’s federal universities who spoke on condition of anonymity said that the implant was to help the nerves function better, stating that it was not only for paraplegics but also useful for quadriplegics; individuals with paralysed arms and legs.
The don said, “It is an invention that is useful anywhere in the world if one has the facility.’’ He added that several tests such as CT scan and Magnetic Resonance Imaging were needed to be carried out to reveal where the problem on the spine was.
Source: HealthWise
