Spinal stimulator helps patients move hands

A devastating dirt bike accident left Brian Gomez with a spinal cord injury and impaired movement in his limbs. Physicians and scientists at Ronald Reagan UCLA Medical Center have developed and implanted a spinal stimulator in the 28-year-old that has increased hand strength and movement.

UCLA scientists implanted the 32-electrode stimulator near Gomez’s C-5 vertebrae, which makes it unique in its placement. Instead of in the brain, the stimulator in the spine is designed to improve the patient’s ability to move their own hands more effectively. Doctors also implanted a small battery pack and processing unit under the skin of the lower back, which is remotely controlled to regulate the frequency and intensity of the stimulations.

"We'd used electrical stimulation to recover paraplegic patients' abilities to stand and move their legs on their own following injury to the lower spine," said neuroscientist Reggie Edgerton, PhD, professor of integrative biology/physiology and neurosurgery at UCLA. "There was considerable skepticism in the field that we could use a similar approach to regain hand function in quadriplegic patients with injury to the upper spine. Brian's strong response to the implant has been very exciting."

Gomez returns to UCLA several times a week for rehabilitation exercises to “fine-tune” the stimulator. While the goal is not to fully restores function of the hands, doctors are hopeful in improving movement enough for patients to successfully perform everyday tasks like tying shoelaces and brushing their teeth.

"The spinal cord contains alternate pathways that it can use to bypass the injury and get messages from the brain to the limbs," said Daniel Lu, MD, PhD, an associate professor of neurosurgery and director of UCLA's neuroplasticity and repair laboratory and the neuromotor recovery and rehabilitation center. "Electrical stimulation trains the spinal cord to find and use these pathways. We can dial up or dial down different parameters and program in the stimulator certain algorithms to activate specific electrodes. It is an ongoing process that retrains the spinal cord and, over time, allows patients to strengthen their grip and regain mobility in their hands."