Epidural Electrical Stimulation for Functional Recovery in Incomplete Spinal Cord Injury

Epidural electrical stimulation (EES) has emerged as a promising treatment for spinal cord injury (SCI). However, the therapeutic potential of EES in functional recovery following incomplete SCI remains limited, with few studies of a large sample size. This study included 11 patients who received EES combined with physical therapy (PT) and 10 who received only PT. Follow-ups were conducted pre-surgery, post-surgery, and at 19 to 25 months postoperatively. After the surgery, patients in the EES + PT group showed significant improvements in sensory function (P < 0.001) and muscle spasticity (P < 0.001). Long-term follow-up indicated that the EES + PT group had significant improvements in sensory function (P < 0.001), muscle spasticity (P < 0.01), and urinary function (P < 0.05). Among them, all 11 patients had improvements in sensory function and muscle spasticity, and 6 of 11 reported an improvement in urinary function. Moreover, of the 5 patients with neuropathic pain, 4 exhibited reduced pain scores. Compared with the PT-only group, the EES + PT group had significantly better recovery in sensory function (P < 0.01), muscle spasticity (P < 0.0001), muscle strength (P < 0.01), and bowel function (P < 0.01). Further analysis suggested that patients with less severe SCIs in the EES + PT group tend to achieve better functional recovery. With a relatively large sample size compared to those in previous studies, this study confirms the promising therapeutic effects of EES in SCI. EES combined with PT provides a potential approach for functional recovery in patients with incomplete SCI.