Treatment of Lower Limb Movement Disorder in Complete Paraplegia Caused By Spinal Cord Injury with Spinal Neuromodulation: A Case Report

Abstract

Spinal Cord Injury (SCI) may result in the impairment of motor, sensory, and voluntary functions below the spinal level of injury. The global prevalence of SCI is 1:1000, with an incidence of 4–9 new cases per 100 000 people per year. The most common causes of traumatic SCI are traffic accidents, falls, and acts of violence. Currently, the prevalence of quadriplegia is comparable to that of paraplegia [1]. To the best of our knowledge, this case report highlights the use of spinal cord stimulation for the first time to treat traumatic complete paraplegia of the lower extremities, with substantial efficacy. We present the case of a 38-year-old Asian male, a truck driver by profession. He had suffered a complete loss of motor and sensory functions in both lower extremities in a traffic accident 3 years ago. The accident also resulted in an AIS-B injury (the sensory function is preserved in the S4-S5 area of the sacral segment, but no motor function is preserved) at the T11/T12 level, accompanied by alternating numbness, deep sensory disturbances, and dyskinesia in both lower extremities, with no spasticity in the legs, and a motor score of 0 for all key leg muscles (No muscle contraction). The patient did not show any clinical improvement in both lower extremities after spinal internal fixation and could not stand or walk (walking index score for SCI: 0), despite extensive rehabilitation in a rehabilitation center. Therefore, with the consent of the patient and his family, we exploratively implanted a Spinal Cord Stimulation (SCS) device in his body on April 26, 2020, to improve the symptoms of the lower extremities.