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July 21, 2020

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Spinal Cord Stimulators Give Robotic Prostheses a Sense of Touch Summary:

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Spinal Cord Stimulators Give Robotic Prostheses a Sense of Touch Summary:

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Researchers have began to use spinal cord stimulators to create a sense of touch in missing limbs of amputees. The goal of this innovation is to give patients a natural way to feel what they normally interact with. The journal eLife published that the spinal cord stimulator leads are implanted near the spinal cord and above nerve roots that relay sensations from the arm and are connected to Nano 2+ Stim Stimulators.The electrodes were energized with signals to reduce pain. This also produced different sensations coming from a volunteer's missing arm. Researchers have been able to produce a feeling of touch in different parts of the phantom arms and hands. This also works for losing the entire arm or serious nerve damage. This article demonstrates the potential that spinal cord stimulators have to restore somatosensation after amputations.

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Participant in the spinal cord stimulator with a right arm amputation:

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Participant in the spinal cord stimulator with a right arm amputation:

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I work at an Ambulatory Surgery Center and one of the procedures we perform are spinal cord stimulator (SCS) implants. I've seen so many patients have great relief from chronic pain with this device. Patients have started weaning off pain medicine because they are getting better relief from the SCS. This is amazing due to the opioid crisis that the healthcare field has faced. I think it would be great to implement these devices with amputee sensation as well.  The results seen are promising to restore sensation for prosthesis and amputations. I do think that the patients need to be individually assessed to obtain surgery risks. If the benefits outweigh the risk, I would advise amputees to try this device for sensation restoration.

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My top 5 strengths are learner, achiever, harmony, futuristic, and responsibility. These strengths will help me lead the team by allowing me to continuous learn from the other team members, lead to achieve a common goal, work in harmony with the team, look toward the future with a similar goal in mind, and hold myself and the team responsible for reaching the goal in a timely fashion.

Alice (Achiever)- Alice will stay on top of getting the project done. She will take action to get things started and moving on to the next step. She is a hard worker and will stay productive. She will be sure to get the project initiated in a timely manner.

Abraham (Arranger)- Abraham will arrange the patient dates and times that they will come in for the trial of this project. He will set up times for the team to meet and make sure that there are no conflicting matters. He will keep the team organized and stay flexible.

Carter (Communication)- Carter will relay information to the patients on when they will come in and how long they will be doing the trial. He will also keep up with how the patients are doing throughout the trial. He will communicate information from patients to the team and vice versa. He will be keep logs with patient data to relay to the team. He is easy to talk to and a great presenter.

Faith (Futuristic)- Faith will do  research to figure out how project can improve the future. She will strive to keep everyone informed on the most up-to-date information about improving the project to better benefit the patients. She will inspire the team to do the best they can during this project.

Pablo (Positivity)-  Pablo will encourage the team and lift spirits no matter how the project is going. He will push everyone to do their best and keep a good attitude. He will be the energetic aspect that is crucial to the team.

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Cons include surgical procedure risks.
Risk of operative side infections, bleeding, movement of the leads.
If the leads get moved out of place this can cause the sensations to not be restored like expected.
More trial testing is needed to determine further cons.

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Spinal cord stimulation (SCS) can restore somatosensory feedback with limb amputations.
SCS can help improve prosthetic control.
SCS is a common Ambulatory Surgery Center procedure used to treat chronic pain.
SCS with upper limb amputations helps control fine movements for object manipulations.
Useful for a wide range of populations including patients with proximal amputations and peripheral neuropathies.
Sensation can be restored regardless of the limb loss level.

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https://www.youtube.com/watch?v=Y6sfgjDKTu0#action=share

This is a link to a video of a study participant and her experience with this technology.

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Authors:
1. Santosh Chandrasekaran- Affiliated with the Rehab Neural Engineering Labs at the University of Pittsburgh. Works with  the Department of Physical Medicine and Rehabilitation.

2. Ameya C. Nanivadekar- Affiliated with the Rehab Neural Engineering Labs at the University of Pittsburgh. Works with the Department of Bioengineering.

3. Gina McKernan- Affiliated with Human Engineering Research Labs, VA Center of Excellence, and Department of Veteran Affairs in Pittsburgh. Works with the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh.

4. Eric R. Helm- Works with the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh.

5. Michael L. Bonginger- Affiliated with Rehab Neural Engineering Labs at the University of Pittsburgh. Works with the Department of Physical Medicine and Rehabilitation, Department of Bioengineering, Human Engineering Research Labs, VA Center of Excellence, Department of Veteran Affairs, and University of Pittsburgh Clinical Translational Science Institute.

6. Jennifer L. Collinger- Affiliated with the Rehab Neural Engineering Labs at the University of Pittsburgh.Works with the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh, Center for Neural Basis of Cognition, Department of Bioengineering, Human Engineering Research Labs, VA Center of Excellence, and the Department of Veteran Affairs.

7. Robert A. Gaunt- Affiliated with the Rehab Neural Engineering Labs at the University of Pittsburgh. Works with the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh, Center for Neural Basis of Cognition, and the Department of Bioengineering.

8. Lee E. Fisher- Affiliated with the Rehab Neural Engineering Labs at the University of Pittsburgh. Works with the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh, Center for Neural Basis of Cognition, and the Department of Bioengineering.

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Chandrasekaran, S., Nanivadekar, A., McKernan, G., Helm, E., Boninger, M., Collinger, J., . . . Fisher, L. (2020, July 21). Sensory restoration by epidural stimulation of the lateral spinal cord in upper-limb amputees. Retrieved September 30, 2020, from https://elifesciences.org/articles/54349

Editors, M. (2020, July 22). Medgadget. Retrieved September 30, 2020, from https://www.medgadget.com/2020/07/spinal-cord-stimulators-give-robotic-prostheses-a-sense-of-touch.html