Spinal implants allow the paralysed to walk, swim and cycle again


FOur year Previously Michelle Roccati was involved in a motorcycle accident. He was suffering from what neurologists call a “complete” spinal cord injury — he lost all sensations under the site of injury to his spine and he could no longer move his legs. did. But last December, a young Italian stood on the streets of Lausanne, Switzerland, and walked a bit.

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After more than a decade of research by Grégoire Courtine, a neuroscientist at the Federal Institute of Technology in Lausanne, and Jocelyne Bloch, a neurosurgeon at Lausanne University Hospital, Roccati’s remarkable steps are underpinned by a wheeled walking frame. I did.

Scientists have attached Roccati with a device that stimulates the nerves in his back, which used to control the muscles of his lower body and legs, but has been dormant since the accident.

Even after severe spinal cord injury, the nerves that control activities such as walking often remain intact under the injured tissue. However, in people with paralysis, damaged tissue blocks or weakens electrical signals from the brain.

Dr. Courtine and Dr. Bloch have developed a wafer thin device with electrodes that can target dormant nerves. Implanted in Roccati’s back, the device sent a pulse of electricity, mimicking what is normally present in nerves when an intact person is walking.

By doing this, the device acted like an amplifier of electrical signals coming from Mr. Roccati’s brain. These signals are usually blocked by damaged spinal tissue and are unable to activate the nerves in the lower back. However, by installing a stimulator, Roccati was able to spontaneously control the nerves that were once dormant, allowing him to move his legs and walk.

Roccati was one of three paralyzed volunteers who participated in a small clinical trial of the device, details of which were published in the journal this week. Nature medicine.. The device worked so well that all three users in the trial were able to get up and perform some steps immediately after recovering from surgery and transplanting.

This was a significant improvement over previous implementations of this type of technology where scientists were reusing neuroimplants commonly used to treat chronic pain. In some cases where these experiments were successful, the patient took months of training to learn to walk again.

Dr. Courtine and Dr. Bloch’s new devices can be configured to emit electrical impulses in many different patterns, each corresponding to a different activity. Patients under test were able to not only stand and walk, but eventually swim and ride a bicycle.

New devices require approval from medical regulatory authorities before they can be used in the clinic. The inventor, in collaboration with the Dutch company Onward Medical, founded a company called NeuroRestore to commercialize new devices.

However, the impact of devices on the lives of those who participated in small Swiss trials has already been dramatic. Roccati emphasizes the little things, such as climbing stairs and taking a shower. At the bar he can get up and chat with his friends. After training, he was able to walk around for two hours every day. “With Walker,” he says. “I am free.” ■■

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This article was published in the Science and Technology section of the print edition under the heading “Standing Ovation”.

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