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Accumulating evidence consistently shows that cervical SCS yields significant improvements in grip force, proximal arm strength and muscle activation, with both immediate and sustained effects. This review synthesizes the evidence that electrical stimulations modulate the spinal and supraspinal organization of uninjured descending motor tracts, primarily the residual corticospinal tract, reticulospinal tract and propriospinal network of neurons, as well as increasing the sensitivity of spinal interneurons at the stimulated segments to these inputs. Additionally, we examine contemporary strategies aimed at achieving more precise patterned stimulations, including intraspinal microstimulation, ventral cord stimulation and closed-loop neuromodulation, and discuss the potential benefits of incorporating cervical SCS into a multimodal treatment paradigm.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Level of evidence:<\/jats:bold>\n                    V\n                  <\/jats:p>","DOI":"10.1177\/17531934241307515","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T11:23:41Z","timestamp":1739273021000},"page":"781-795","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Cervical spinal cord stimulation for treatment of upper limb paralysis: a narrative review"],"prefix":"10.1177","volume":"50","author":[{"given":"Yu Tung","family":"Lo","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, National Neuroscience Institute, Singapore"},{"name":"Department of Neurosurgery, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan LW","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2727-0863","authenticated-orcid":false,"given":"Lei","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Division of Spine Surgery, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wee Leon","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor R","family":"Edgerton","sequence":"additional","affiliation":[{"name":"Rancho Research Institute, Ranchos Los Amigos National Rehabilitation Hospital, Downey, California, United States"},{"name":"Neurorestoration Center, University of Southern California, Los Angeles, California, United States"},{"name":"Scientific Advisory Board, Guttmann Institute, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles Y","family":"Liu","sequence":"additional","affiliation":[{"name":"Scientific Advisory Board, Guttmann Institute, Barcelona, Spain"},{"name":"Department of Neurosurgery, Ranchos Los Amigos National Rehabilitation Hospital, Downey, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00089.2011"},{"key":"e_1_3_5_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2019.00253"},{"key":"e_1_3_5_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2004.21.1371"},{"key":"e_1_3_5_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awu038"},{"key":"e_1_3_5_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.772199"},{"key":"e_1_3_5_7_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2011.215160"},{"key":"e_1_3_5_8_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.3368-16.2017"},{"key":"e_1_3_5_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2013.00284"},{"key":"e_1_3_5_10_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2005.094516"},{"key":"e_1_3_5_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/nn1195"},{"key":"e_1_3_5_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00429-020-02171-x"},{"key":"e_1_3_5_13_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.2374-19.2020"},{"key":"e_1_3_5_14_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1217416"},{"key":"e_1_3_5_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9861(19970922)386:2<293::AID-CNE9>3.0.CO;2-X"},{"key":"e_1_3_5_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fncir.2018.00030"},{"key":"e_1_3_5_17_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.5852-08.2009"},{"key":"e_1_3_5_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3100364"},{"key":"e_1_3_5_19_1","first-page":"141","article-title":"Clinical evaluation of the effect of spinal cord stimulation on motor performance in patients with upper motor neuron lesions","volume":"44","author":"Campos RJ","year":"1981","unstructured":"Campos RJ, Dimitrijevic MM, Faganel J, Sharkey PC. 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