Epidural Stimulation and Rehabilitation for Spinal Cord Injury

Istanbul Gelisim University29 enrolled

Overview

Spinal cord injury involving the conus region often results in severe impairments in mobility, self-care, and bladder and bowel function, substantially reducing independence and quality of life. Epidural electrical stimulation (EES), combined with structured rehabilitation, has emerged as a promising neuromodulation strategy for improving functional recovery; however, evidence in patients with conus-region involvement remains limited. This exploratory cohort study aims to evaluate functional changes following EES integrated with a standardized rehabilitation program in individuals with spinal cord injury involving the conus region. Functional independence is assessed using the Spinal Cord Independence Measure (SCIM) at baseline and during follow-up. The study also evaluates changes in SCIM subdomains related to self-care, respiration and sphincter management, and mobility, while monitoring the safety of EES throughout the rehabilitation period. The findings are expected to provide preliminary evidence regarding the feasibility, safety, and potential functional benefits of combining epidural electrical stimulation with structured rehabilitation in this specific spinal cord injury population.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Spinal Cord Injury Conus Medullaris Injury Conus Region Involvement

Interventions

Participants received individualized epidural electrical stimulation delivered through an implanted epidural stimulation system in combination with a structured rehabilitation program. Stimulation parameters were adjusted according to clinical response, and rehabilitation included task-oriented exercises, balance training, standing, gait preparation, and functional mobility exercises throughout the 6-month follow-up period.

Eligibility

Sex: ALLMin age: 17 YearsMax age: 61 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults and adolescents aged 17 to 61 years. * Diagnosis of chronic spinal cord injury involving the conus region (T12 and/or L1). * Underwent epidural electrical stimulation (EES) combined with a structured rehabilitation program. * Available baseline and follow-up Spinal Cord Independence Measure (SCIM) assessments. * Provided written informed consent or consent was obtained from a legally authorized representative. Exclusion Criteria: * Spinal cord injury without conus-region involvement. * Missing baseline or follow-up functional assessment data. Incomplete clinical records preventing outcome evaluation. * Contraindications to epidural electrical stimulation or inability to participate in the rehabilitation program.

Outcomes

Primary Outcomes

Change in Total Spinal Cord Independence Measure (SCIM) Score

The primary outcome is the change in total Spinal Cord Independence Measure (SCIM) score between baseline and the 6-month follow-up. The SCIM assesses functional independence in individuals with spinal cord injury, with scores ranging from 0 to 100; higher scores indicate greater functional independence.