spinal stimulator implanted by doctors at Ronald Reagan UCLA Medical Center is showing early promise in returning hand
strength and movement to a California man who broke his neck in a
dirt-biking accident five years ago.
Brian Gomez, 28, became one of the world's first patients to undergo surgery for the experimental device in June 2016.
‘A 32-electrode stimulator implanted below the site of upper spinal-cord injury may help regain hand function in quadriplegic patients.’
UCLA scientists positioned the 32-electrode stimulator below the
site of Gomez's spinal-cord injury, near the C-5 vertebrae in the middle
of his neck. That's the area most commonly associated with
quadriplegia, or loss of function and feeling in all four limbs.
"The spinal cord contains alternate pathways that it can use to
bypass the injury and get messages from the brain to the limbs," said
Daniel Lu, an associate professor of neurosurgery and
director of UCLA's neuroplasticity and repair laboratory and the
neuromotor recovery and rehabilitation center. "Electrical stimulation
trains the spinal cord to find and use these pathways."
While other devices have shown promise recently in treating
paralysis, these approaches involved animals or relied on robotic arms.
This approach is unique because the device is implanted in the spine
instead of the brain, and is designed to boost patients' abilities to
move their own hands.
Lu likened the approach to a commute on a busy freeway. "If there is
an accident on the freeway, traffic comes to a standstill, but there
are any number of side streets you can use to detour the accident and
get where you are going," he said. "It's the same with the spinal cord."
In addition to the stimulator, doctors implant a small battery pack
and processing unit under the skin of the patient's lower back. Small
enough to fit in the palm of your hand, the implant is paired with a
remote control that patients and doctors use to regulate the frequency
and intensity of the stimulation.
"We can dial up or dial down different parameters and program in the
stimulator certain algorithms to activate specific electrodes," said
Lu. "It is an ongoing process that retrains the spinal cord and, over
time, allows patients to strengthen their grip and regain mobility in
The UCLA team performed the world's first implant surgeries of this
kind on two cervical spinal-cord injury patients prior to Gomez. Lu and
his colleagues saw an increase in finger mobility and grip strength of
up to 300%.
The current study is funded by the National Institute of Biomedical
Imaging and Bioengineering, part of the National Institutes of Health.
Lu is working with UCLA neuroscientist Reggie Edgerton, to
build upon the success of their previous findings in patients with
lumbar spinal-cord injuries.
"We'd used electrical stimulation to recover paraplegic patients'
abilities to stand and move their legs on their own following injury to
the lower spine," said Edgerton, a distinguished professor of
integrative biology/physiology and neurosurgery at UCLA's David Geffen
School of Medicine and College of Letters and Science. "There was
considerable skepticism in the field that we could use a similar
approach to regain hand function in quadriplegic patients with injury to
the upper spine. Brian's strong response to the implant has been very
"It's making a huge difference for me," said Gomez, who owns a
coffee-roasting business in his hometown of San Dimas, California.
"I use an industrial roaster that heats up to 450 degrees and just a
few months ago, I reached up to pull a lever to empty a batch of beans
after they'd finished roasting," said Gomez. "But because I didn't have
the arm or core strength, I burned myself," he said pointing to a scar
on his forearm. "That doesn't happen anymore because of the strength and
dexterity I've developed."
Gomez's improvements are especially encouraging given the five years
that passed between his injury and surgery. People who suffer
spinal-cord injuries usually have a window of only a few months to get
the rehabilitation they need in order to maintain at least partial use
of their hands. Meaningful improvement is rare more than a year after
"Even though he was injured in 2011, in many ways Brian is a perfect
candidate for this experimental treatment. He still has head-to-toe
sensation, so he can give us feedback as we fine-tune the stimulator.
And he is such a positive and motivated young man," said Lu.
Several times a week, Gomez returns to a laboratory at UCLA, where a
team of scientists put him through rehabilitation exercises and
continue to fine-tune the stimulator. "It takes a lot of time and
commitment to do this, but I'm determined," said Gomez. "Things are
about to change for the better, so I'm excited about what's to come."
The UCLA team's goal is not to fully restore hand function, but to
improve it enough to allow patients to perform everyday tasks - still a
remarkable achievement considering the length of time since their
injuries. As the technology develops, patients might be able to expect
Researchers evaluate hand strength by measuring a unit known as a newton of force.
"A normal hand is able to impart about 100 to 200 newtons of force,
but after an accident, that often drops to only one or two newtons of
force," said Lu. "Our goal is to get these patients back to the 20 to 30
range. That will allow them to do everyday tasks and will make a huge
difference in the quality of their lives."
Tasks like tying their shoes and brushing their teeth. Or, in Brian
Gomez's case, holding and sipping a cup of coffee that he roasted and