Spinal Cord Stimulation

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Neurodegenerative diseases and central nervous system disorders—such as dementia, hydrocephalus, Parkinson’s disease, spinal cord injury, and stroke—currently lack effective treatment options. Our team is working to improve these conditions through neuromodulation and personalized rehabilitation strategies. Our current clinical applications and research directions include:

Neuromodulation to improve upper and lower limb function, enabling previously immobile limbs to regain movement.
Physiological signal and motion data analysis as a basis for personalized clinical assessment and precision medicine.
Evaluating sensory and motor recovery in patients with neurodegenerative and central nervous system disorders after combining neuromodulation and personalized rehabilitation.
Integrating personalized rehabilitation and exoskeleton-assisted training to enhance neuroplasticity and slow neurodegeneration through advanced precision medicine.

Epidural Electrical Stimulation (EES) is a clinically proven treatment for chronic neuropathic pain. The therapy involves implanting electrodes in the epidural space of the spinal cord to deliver electrical impulses that block pain signals from reaching the brain. In addition to interrupting pain transmission, this stimulation modulates cortical activity in the brain, effectively controlling neuropathic pain. EES has been used to treat various types of pain, including diabetic ischemic neuropathy, postherpetic neuralgia, and refractory angina, with several clinical reports confirming its effectiveness.

In recent years, both animal and clinical studies have explored EES in the treatment of spinal cord injury (SCI). Neuromodulation, combined with rehabilitation training, has been shown to reactivate neural connections between the brain and spinal cord, enabling animals like monkeys and rodents to regain walking abilities.

Since 2019, building on the foundation of treating chronic neuropathic pain, our team has been conducting clinical research (currently in Phase I trials) to evaluate the effectiveness of EES in improving lower limb function in patients with spinal cord injury. Over the past few years, we have established the following:

Clinical Assessment Standards
Using tools such as MRI, electromyography (EMG), electroencephalography (EEG), and single-pulse transcranial magnetic stimulation (sTMS) combined with motor evoked potentials (MEPs) and gait analysis, we have developed a digital platform for the objective and detailed evaluation of residual neural pathways, nerve conduction capacity, and muscle strength. This platform complements traditional clinical scales and provides critical insights for intraoperative electrode implantation, postoperative neuromodulation, and rehabilitation planning.
Standardized Intraoperative Localization Protocol
To achieve precise control of specific muscle groups, we utilize preoperative MRI and assessment data for surgical planning. During the procedure, real-time EMG monitoring and intraoperative imaging guide the placement of electrodes, enabling successful control of lower limb muscle groups post-surgery.
Multi-modal Electrical Stimulation Rehabilitation Planning
After surgery, we use real-time EMG monitoring to adjust stimulation parameters, enhancing muscle strength. Based on each patient’s preoperative evaluation, we design individualized multi-modal EES rehabilitation programs.
Advanced Robotic-Assisted Gait Training
In the chronic phase of SCI, patients often experience a plateau in recovery and face limited access to rehabilitation resources. Traditional rehabilitation focuses on maintaining existing function, but EES aims to restore lost motor function. To support this goal, Hualien Tzu Chi Hospital has introduced three types of exoskeleton robots suited for different functional levels. With EES treatment and guidance from specialized physical therapists, patients can engage in various weight-bearing walking exercises to strengthen muscles and improve gait.

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