Closed-loop spinal neural interface combined with rehabilitation training for incomplete spinal cord injury: a case report

Spinal cord injury (SCI) is a major cause of motor disability. Epidural electrical stimulation (EES) has emerged as a promising neuromodulation technique and has been extensively investigated in recent years for promoting functional recovery after SCI. This case report describes a patient who sustained a thoracic SCI four months ago due to a fall from height. Following surgical intervention and conventional rehabilitation, the patient's lower limb muscle strength remained at grade C on the American Spinal Injury Association (ASIA) impairment scale. After implantation of a closed-loop spinal neural interface for EES, the patient underwent a regimen of continuous stimulation with spatially targeted configurations and multimodal rehabilitation training. This intervention led to progressive recovery, including the achievement of voluntary single-joint movements, independent standing, and assisted walking. At the 16-week follow-up, the patient's ASIA grade improved from C to D. Improvements were also noted in sensory and autonomic functions in addition to motor recovery. The overall rehabilitation outcomes were substan-tially better than those typically reported for chronic-phase SCI patients in the literature. Importantly, no implant-related infections or neurological complications were observed. These results indicate that the combination of closed-loop spinal neural interface-enabled EES and structured rehabilitation holds significant potential as a therapeutic strategy.