Spinal implants allow Michelle Roccatti to move independently. Swiss researchers have used implants and artificial intelligence to restore movement to three paralyzed patients. Electronic implants have allowed people who were completely paralyzed due to spinal cord injuries to stand, walk, swim, and even ride a bicycle for the first time.
In 2018, scientists from the Federal Polytechnic School of Lausanne and the University Hospital of Lausanne announced that they had succeeded in restoring the mobility of the legs of patients with paralysis of the lower extremities and partial spinal injuries. Now, they have improved the technology with new implants and AI-based software, and were able to restore trunk and leg function in three patients whose lower limbs were completely immobilized. The study was published in Nature Medicine.
“All three patients were able to stand, walk, pedal, swim and control their body movements just one day after the activation of the implants,” says Gregoir Curtin, professor at the Polytechnic University of Lausanne and one of the project leaders. “This is possible thanks to special stimulation programs that we have written for each type of activity. Patients select the desired intensity of a particular type of movement on a small tablet computer, which wirelessly transmits instructions to the pacemaker in the abdominal cavity and then to a set of electrodes implanted in the lower part of the spinal cord below the site of the injury. These stimulate nerve cells to initiate muscle movement.
One of the patients, Michel Roccatti, was paralyzed in a motorcycle accident four years ago. We explain quickly, simply, and clearly what happened, why it matters, and what will happen next. The number of offers should remain: Episodes End of story: Podcast Advertising. In a healthy person, nerves in the spinal cord send signals from the brain to the leg muscles. In Rokkati’s case, no signals reach his legs because his spinal cord is completely severed. But the implant sends signals directly to his legs, allowing him to walk, but only when the implant is turned on.
“The first steps were incredible – a dream come true,” Rokkati said of his experience with the implants before publishing the research. Intensive training over several months strengthened muscles weakened by years of inactivity and trained the brain to stand and move. “I set some goals for myself,” Roccatti said. “For example, I can now walk up and down stairs, and I hope to be able to walk one kilometer [with crutches] by spring.”
The first successes, which scientists reported in 2018, were achieved using repurposed electrodes originally intended for pain relief. In this new study, doctors used electrodes placed along the spinal cord just below the vertebrae, which the team developed in collaboration with Onward, a medical device company based in the Netherlands and Switzerland. “We have been able to create longer and wider implants with electrodes positioned to correspond exactly to the roots of the spinal nerves,” said Joseline Bloch, the neurosurgeon who implanted them. “This gives us precise control over the neurons that control specific muscles.”
Blokh and Kurtin are now working to further improve the technology, miniaturize some of the components, and make the system easier for paraplegic patients to use. However, the scientists caution that their technology is not yet ready for widespread use: they believe it will be several years before it undergoes clinical trials and becomes a common method of treating paraplegia.
“This is not a cure-all for spinal cord injury,” says Kurtin. “But it is an important step in improving the quality of life for patients. We are going to expand people’s abilities, allow them to stand, take a few steps. It is not enough, of course, but it is progress. Full recovery will require spinal cord regeneration, possibly using stem cell therapy. These studies are in the very early stages. Professor Kurtin believes that implants, once developed and tested, could be used in combination with nerve regeneration procedures.
All six volunteers in the two studies had been paralyzed for several years. The researchers also plan to test the new implants in people who have recently suffered spinal cord injuries: they may respond better to electronic stimulation because their nerves and muscles have atrophied less. To date, nine people have received implants and regained the ability to walk. None of them use them to move around in everyday life – it is too difficult at this stage. Instead, they activate the implants for walking exercises that train muscles, improve health, and often partially restore mobility. However, David M’zi, who received the first implants in the 2018 study, reported that his health has improved to the point that he now kitesurf on Swiss lakes and has become a father.
David M’zi with his daughter