Spinal and spinal injuries (PSMT)

Main article: Human body

Spinal fracture

Main article: Spinal fracture

2022: Implant coming to market to help splice damaged spine

In late February 2022, medical technology specialist Intelligent Implants introduced the SmartFuse TLIF spinal implant. The device is intended for improving bone healing and reducing the frequency of non-fusion after vertebral fusion surgery. The implant is equipped with electrodes that are designed to enhance bone growth as well as monitor bone healing, and the technology itself may have potential in orthopedic areas other than the spine. Read more here.

2020: FEFU: neurorehabilitation of patients with severe back injury

On December 11, 2020, it became known that scientists from the School of Biomedicine of the Far Eastern Federal University (FEFU) and the FEFU NTI Center for Neurotechnologies, VR and AR, together with other experts, proposed to revise the current practice of spastic syndrome therapy, one of the main complications after severe spinal injuries with a partial spinal cord break, which entails deterioration of the patient's condition and sharply limits the possibilities of rehabilitation. This treatment protocol has already been implemented at the FEFU Medical Center. An article about this was published in Progress in Brain Research.

According to the company, scientists have developed a personalized selection protocol for paralyzed patients with back injury and severe spastics for surgical treatment - implantation of a spinal cord stimulator or baclofen pump. These alternative methods were first compared with two experimental groups.

When selected for the operation, FEFU specialists proposed to conduct preliminary experimental stimulation of the spinal cord for patients for 3-5 days, and in the absence of a response to stimulation by current pulses, test their body for response to baclofen. This is an important stage, as a result of which the doctor together with the patient decides what to implant.

The researchers noted that at month 12 after surgery, both groups of patients showed improvements compared to controls, with baclofen pump patients also showing improved motor skills. Despite this, scientists argue that spinal cord stimulation (SCS) is a more promising therapy technique and propose to revise the current world practice of therapy for patients with severe spinal injuries.

Every year in the world, about 800 thousand people receive a combined spinal injury with a spinal cord break - this is a very severe injury, in which only every third victim survives. As a rule, these are completely paralyzed disabled people, and what is especially sad, these are mostly young people aged 20-25 years. Spastic syndrome develops in 80% of patients, it sharply limits the possibilities of rehabilitation and provokes severe complications. Baclofen pump implantation (ITB) is the most common treatment for such patients. A device is implanted into the human body that delivers baclofen to the spinal cord, thereby causing a decrease in muscle tone. The method is associated with a large number of complications and risks, but, most importantly, it almost forever binds the patient to such therapy, depriving him of even hope for improvement. told Igor Bryukhovetsky, head of the laboratory of molecular and cellular neuroscience of the Department of Fundamental Medicine of the School of Biomedicine

Neuromodulation of the spinal cord by electricity with a small implantable stimulator (SCS) is another step in addressing the problem of verticalization and motor rehabilitation of people after a severe spinal injury. Such an operation gives paralyzed patients additional hope for the maximum possible recovery.

The bottom line is that signals from the stimulator are directed to electrodes implanted on the spinal cord and help activate neuronal circuits below the injury. Neural networks become able to receive commands from the brain, activating neurons in the spinal cord that are responsible for the functioning of the muscles of the legs.

According to the accumulated data, a complete anatomical break of the spinal cord is a rather rare phenomenon, and in the event of a partial break, some recovery is possible. Systematic neuroprotection and regenerative therapy, including the use of biomedical cell products, is the main task of the first or second year of treatment, during which a significant improvement in neurological functions is possible. This requires a fundamentally different approach to the therapy of spastic syndrome. One of the options for solving the problem is to implant a spinal cord stimulation system (SCS), which allows you to reduce spasticity by suppressing pathological impulses in the spinal cord with an electric current. told Arthur Biktimirov, one of the authors of the study, neurosurgeon of the FEFU Medical Center, analyst at the FEFU NTI Center

The scientist clarified that in patients with a complete rupture of the spinal cord, the rehabilitation potential is minimal. However, it is spinal cord stimulation that opens up opportunities for motor neurorehabilitation at stages when other methods are not working.

The study took into account the treatment results of 66 FEFU Medical Center patients with spinal cord injury and severe spastika between the ages of 18 and 62, who were paralyzed below the level of injury. The mean age of the patients was 36 years. The first group of 18 people, in accordance with the results of preliminary testing, implanted a spinal cord neurostimulation device, the second, out of 15, - pumps with baclofen. The rest of the patients preferred conservative operative treatment and entered the control group.

The neuromodulation technique is being developed on the basis of the FEFU School of Biomedicine, the FEFU Medical Center and the FEFU NTI Center for Neurotechnologies, Virtual (VR) and Augmented Reality (AR) in cooperation with Russian and foreign experts.

See also

Traumatic brain injuries (TBI)