A motorbike crash severed Michel Roccati’s spine 5 years ago.
People such as Roccati who have been in an accident that completely separates part of their body from their brain are often given a prognosis that involves a permanent loss of mobility.
In Roccati’s case, he lost all movement and feeling in his legs.
Yet Roccati now walks, thanks to Swiss researchers who have developed an electrical implant that doctors surgically attached to his spine last year.
It’s the first time someone with a completely severed spine has been able to walk again.
The brain sends signals to the legs via nerves in the spinal cord when a human decides to walk. When the spine is damaged, the signals are often too weak to create movement.
The new implant boosts those signals, enabling the person to be mobile again.
The researchTrusted Source was recently published in the journal Nature Medicine, which also documented how the technology helped another man with paralysis become a father.
The technology’s potential
The BBC spoke to Roccati at the Swiss lab where the implant was created.
“I stand up, walk where I want to. I can walk the stairs. It’s almost a normal life,” the Italian man said. “I used to box, run, and do fitness training in the gym. But after the accident, I could not do the things that I loved to do, but I did not let my mood go down. I never stopped my rehabilitation. I wanted to solve this problem.”
Nine people have received the implant so far.
None use it to walk in everyday life. They use it to practice walking at this stage, which exercises other muscles and offers improving movement.
Dr. Rahul Shah, a board certified orthopedic spine and neck surgeon at Premier Orthopaedic Associates in New Jersey, told Healthline the implant could change everything about spinal injuries.
“It builds on an existing technology that has been used for a long time for people who have chronic pain. The new advancement allows for electrical impulses to go to the spine and then basically deliver the spine [a] succession of impulses so that the electricity to the legs and trunk is restored,” Shah said.
“In the past, this type of electricity was used to confuse the body, so it did not feel the same pain — similar to when someone has an issue with their leg and rubs their leg,” he explained.
“With this study, they have made some further modifications,” Shah added. “It appears they made a miraculous improvement on folks getting them to use their lower extremities and trunk in areas that were previously paralyzed.”
“If this is reproducible, since this study shows a small number, this could be extremely exciting for us to help those who have been injured with devastating spinal cord injuries,” he said. “It will help us to keep people’s muscles active in those who have had injuries and potentially help them use their muscles in a more functional manner.”
“Will they be like they were before their injury? At least in the initial experiment, no,” Shah said. “But will they be a lot further than they currently are today if this research proves out over multiple people? Absolutely.”
Advances in the field of paralysis
Researchers say the development of the implant isn’t a cure-all for spinal injuries.
However, it is part of a growing body of advances in recent years that offer hope.
“Epidural stimulation for spinal cord injury is a game-changer,” said Dr. Uzma Samadani, the president and CEO of US Neurosurgery Associates and a neurosurgeon at Minneapolis VA Medical Center.
Samadani is also an associate professor of bioinformatics and computational biology at the University of Minnesota.
“The field is still in its infancy, but it has already changed what we thought we understood about spinal cord injury,” she told Healthline. “For example, we used to think of injury as ‘complete’ or ‘incomplete’ depending on how much function people still had after the injury. Now we know that function can be ‘rescued.’”
Samadani noted that other new advancements include treatments involving stem cells and small molecules that inhibit scar formation and prevent recovery.
“I would estimate that more than 100 spinal cord injured patients in the U.S. have already been implanted with stimulators, either as part of a trial, for complex regional pain syndrome, or off-label,” she said. “The hardest part is programming the stimulator so that it is useful after implantation.”
“I think this gives considerable hope to people currently paralyzed,” Samadani added. “The caution is that many have lost so much bone density and muscle mass that recovering the ability to walk is much more of a challenge.”
In November, Northwestern University researchers announced they’d developed a new injectable therapy harnessing “dancing molecules” that can reverse paralysis and repair tissue after severe spinal cord injuries.
A single injection to tissues surrounding spinal cords of paralyzed mice had them walking again in 4 weeks. The research was published in the journal Science.
Scientists at University of Washington announced in January 2021 that they’d helped six Seattle-area people with paralysis regain some hand and arm mobility using a method combining physical therapy with a noninvasive method of stimulating nerve cells in the spinal cord.
The increased mobility lasted 3 to 6 months after treatment ended. That research was published in the journal IEEE Xplore.
Looking ahead
Shah said there will be regulatory and supply chain speed bumps delaying the availability of the implant.
There will also need to be more research on how the implant affects surrounding muscles and the longevity of the device itself.
But Shah said the new technology offers hope.
“We have to see what happens in 5 to 10 years,” he said. “Sometimes we get miraculous improvements, but the question is whether we can sustain it.”
