“I felt the ball” – Future of Spine Injury Recovery

Salman Sharif MD, Spine Surgeon, Pakistan; POSTED 2/3/21
World Neurosurgery 2020
Article that every Neurosurgeon and Neurologist should read
Plz share with all your friends and juniors
https://www.researchgate.net/…/341562599_I_felt_the…

Abstract and Figures

Spinal cord injury (SCI) has no cure and individuals with SCI become dependent on others for life. After injury, the signals below the lesion are disrupted, but the brain still produces motor commands. Researchers have bypassed this obstacle, which has given rise to the brain-machine interface (BMI). BMI devices are implanted in the brain or spinal cord, where they decode and send signals beyond the injured segment. Experiments were initially conducted on animals, with favorable results. BMIs are classified according to their type, function, signal generation, and so on. Because of invasiveness, their long-term use is questionable, because of infections and complications. The use of an implantable epidural array in patients with chronic SCI showed that participants were able to walk with the help of a stimulator, and after months of training, they were able to walk with the stimulator turned off. Another innovation is a robotic suit for paraplegics and tetraplegics that supports the movement of limbs. The research on stem cells has not shown favorable results. In future, one of these cutting-edge technologies will prevail over the other, but BMI seems to have the upper hand. The future of BMI with fusion of robotics and artificial intelligence is promising for patients with chronic SCI. These modern devices need to be less invasive, biocompatible, easily programmable, portable, and cost-effective. After these hurdles are overcome, the devices may become the mainstay of potential rehabilitation therapy for partial recovery. The time may come when all patients with severe SCI are told “You will walk again.”
Juliano Pinto at 2014 FIFA World Cup in Brazil. The man in the middle is showing the exosuit supporting the body in an upright position.
Juliano Pinto at 2014 FIFA World Cup in Brazil. The man in the middle is showing the exosuit supporting the body in an upright position.
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Brainemachine interface concept shows a device that is implanted in the brain, and a wire is passed beneath the skin and embedded in the spinal cord beyond the injured site to bypass these signals, which are blocked because of injury.
Brainemachine interface concept shows a device that is implanted in the brain, and a wire is passed beneath the skin and embedded in the spinal cord beyond the injured site to bypass these signals, which are blocked because of injury.
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Control of muscle, electric chair, and a robotic arm with brainemachine interface. This figure shows the various applications of brainemachine interface as
Control of muscle, electric chair, and a robotic arm with brainemachine interface. This figure shows the various applications of brainemachine interface as
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Brainemachine interface in a patient with spinal cord injury showing low-level spinal injury causing paraplegia. An implanted device helps bypass signal beyond the injured site and aids in walking via electric stimulation.
Brainemachine interface in a patient with spinal cord injury showing low-level spinal injury causing paraplegia. An implanted device helps bypass signal beyond the injured site and aids in walking via electric stimulation.
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Epidural array stimulation, showing an epidural array (left) implanted in the patient beyond the injured segment of the spinal cord. Sequential
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Epidural array stimulation, showing an epidural array (left) implanted in the patient beyond the injured segment of the spinal cord. Sequential
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