{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T02:11:11Z","timestamp":1789179071309,"version":"build-2803163510"},"reference-count":23,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T00:00:00Z","timestamp":1661817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>A 25-year-old male with T3 complete AIS A was implanted with percutaneous spinal cord epidural stimulation (scES; eight contacts each) leads and a Medtronic Prime advance internal pulse generator. The two leads were placed at the midline level to cover the region of the T11\u2013T12 vertebrae. Five days after implantation, X-ray showed complete migration of the left lead outside the epidural space. Two weeks after implantation, reprogramming of the single right lead (20 Hz and 240 \u00b5s) after setting the cathode at 0 and the anode at 3 resulted in target activation of the abdominal muscles and allowed for the immediate restoration of trunk control during a seated position, even with upper extremity perturbation. This was followed by achieving immediate standing after setting the single lead at \u22123 for the cathode and +6 for the anode using stimulation configurations of 20 Hz and 240 \u00b5s. The results were confirmed with electromyography (EMG) of the rectus abdominus and lower extremity muscles. Targeted stimulation of the lumbosacral segment using a single lead with a midline approach immediately restored the trunk control and standing in a person with complete paraplegia.<\/jats:p>","DOI":"10.3390\/jcm11175120","type":"journal-article","created":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T00:13:56Z","timestamp":1661904836000},"page":"5120","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Single Lead Epidural Spinal Cord Stimulation Targeted Trunk Control and Standing in Complete Paraplegia"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9157-6034","authenticated-orcid":false,"given":"Ashraf","family":"Gorgey","sequence":"first","affiliation":[{"name":"Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, 1201 Broad Rock Boulevard, Richmond, VA 23249, USA"},{"name":"Department of Physical Medicine & Rehabilitation, Virginia Commonwealth University, Richmond, VA 23298, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Gouda","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Louran Hospital, Alexandria 5451110, Egypt"},{"name":"Department of Surgery, Wright State University, Dayton, OH 45435, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"254","DOI":"10.3171\/spi.2004.100.3.0254","article-title":"Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: A 20-year literature review","volume":"100","author":"Cameron","year":"2004","journal-title":"J. Neurosurg. Spine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"379","DOI":"10.36076\/ppj.2009\/12\/379","article-title":"Spinal cord stimulation for patients with failed back surgery syndrome: A systematic review","volume":"12","author":"Frey","year":"2009","journal-title":"Pain Physician"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1016\/S0140-6736(11)60547-3","article-title":"Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: A case study","volume":"377","author":"Harkema","year":"2011","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1056\/NEJMoa1803588","article-title":"Recovery of over-ground walking after chronic motor complete spinal cord injury","volume":"379","author":"Angeli","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1038\/s41586-018-0649-2","article-title":"Targeted neurotechnology restores walking in humans with spinal cord injury","volume":"563","author":"Wagner","year":"2018","journal-title":"Nature"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1002\/acn3.50983","article-title":"The feasibility of using exoskeletal-assisted walking with epidural stimulation: A case report study","volume":"7","author":"Gorgey","year":"2020","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1002\/acn3.51508","article-title":"Epidural stimulation with locomotor training ameliorates unstable blood pressure after tetraplegia. A case report","volume":"9","author":"Gorgey","year":"2022","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1097\/BRS.0000000000000276","article-title":"Patient characteristics associated with increased postoperative length of stay and readmission after elective laminectomy for lumbar spinal stenosis","volume":"39","author":"Basques","year":"2014","journal-title":"Spine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"E842","DOI":"10.1097\/BRS.0000000000002563","article-title":"Outcomes and complications following laminectomy alone for thoracic myelopathy due to ossified ligamentum flavum","volume":"43","author":"Osman","year":"2018","journal-title":"Spine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"101930","DOI":"10.1016\/j.isci.2020.101930","article-title":"Spinal motor mapping by epidural stimulation of lumbosacral posterior roots in humans","volume":"24","author":"Hofstoetter","year":"2021","journal-title":"Iscience"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1159\/000099381","article-title":"Effects of spinal cord stimulation on spasticity and spasms secondary to myelopathy","volume":"51","author":"Barolat","year":"1988","journal-title":"Stereotact. Funct. Neurosurg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1038\/sj.sc.3101615","article-title":"Stepping-like movements in humans with complete spinal cord injury induced by epidural stimulation of the lumbar cord: Electromyographic study of compound muscle action potentials","volume":"42","author":"Minassian","year":"2004","journal-title":"Spinal Cord"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2633","DOI":"10.1523\/JNEUROSCI.2374-19.2020","article-title":"Cortical and subcortical effects of transcutaneous spinal cord stimulation in humans with tetraplegia","volume":"40","author":"Benavides","year":"2020","journal-title":"J. Neurosci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1843","DOI":"10.1152\/jn.00020.2021","article-title":"Epidural spinal cord stimulation as an intervention for motor recovery after motor complete spinal cord injury","volume":"126","author":"Hachmann","year":"2021","journal-title":"J. Neurophysiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"6639801","DOI":"10.1155\/2021\/6639801","article-title":"A retrospective review of lead migration rate in patients permanently implanted with percutaneous leads and a 10 kHz SCS device","volume":"2021","author":"Gupta","year":"2021","journal-title":"Pain Res. Manag."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1152\/jn.00489.2013","article-title":"Neuromodulation of evoked muscle potentials induced by epidural spinal-cord stimulation in paralyzed individuals","volume":"111","author":"Sayenko","year":"2014","journal-title":"J. Neurophysiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"79","DOI":"10.3389\/fnsys.2020.569337","article-title":"Epidural Electrical Stimulation of the Lumbosacral Spinal Cord Improves Trunk Stability During Seated Reaching in Two Humans With Severe Thoracic Spinal Cord Injury","volume":"14","author":"Gill","year":"2020","journal-title":"Front. Syst. Neurosci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1111\/cns.12530","article-title":"Spinal cord stimulation and augmentative control strategies for leg movement after spinal paralysis in humans","volume":"22","author":"Minassian","year":"2016","journal-title":"CNS Neurosci. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Rejc, E., Angeli, C., and Harkema, S. (2015). Effects of lumbosacral spinal cord epidural stimulation for standing after chronic complete paralysis in humans. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0133998"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Calvert, J.S., Gill, M.L., Linde, M.B., Veith, D.D., Thoreson, A.R., Lopez, C., Lee, K.H., Gerasimenko, Y.P., Edgerton, V.R., and Lavrov, I.A. (2021). Voluntary modulation of evoked responses generated by epidural and transcutaneous spinal stimulation in humans with spinal cord injury. J. Clin. Med., 10.","DOI":"10.3390\/jcm10214898"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1016\/j.mayocp.2020.07.039","article-title":"Segment-specific orientation of the dorsal and ventral roots for precise therapeutic targeting of human spinal cord","volume":"96","author":"Mendez","year":"2021","journal-title":"Mayo Clin. Proc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1002\/ejp.1336","article-title":"Mechanisms of spinal cord stimulation for the treatment of pain: Still in the dark after 50 years","volume":"23","author":"Jensen","year":"2019","journal-title":"Eur. J. Pain"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1111\/ner.13487","article-title":"Incidence and risk factors for spinal cord stimulator lead migration with or without loss of efficacy: A retrospective review of 91 consecutive thoracic lead implants","volume":"25","author":"Ha","year":"2022","journal-title":"Neuromodulation Technol. 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