Epidural Spinal Cord Stimulation Helps Restore Locomotion in an Individual with Subacute Combined Degeneration: A Case Report

Abstract

Background: Subacute combined degeneration (SCD) of the spinal cord with corticospinal tract involvement can impair motor functions below the level of the lesion. Case Report: A 63-year-old man developed progressive bilateral lower extremity weakness marked by difficulty standing for more than a second and the inability to ambulate, causing him to become wheelchair-bound. He was diagnosed with SCD. His vitamin B12 level was corrected and he underwent physical therapy. Despite these interventions, he experienced an overall deterioration in his strength examination. He later underwent an epidural spinal cord stimulator trial with pulsed electrical stimulation. With this, he experienced improvement in his lower extremity strength and regained the ability to ambulate independently. Permanent leads were placed with the retained faculty to ambulate with the stimulator turned on. Conclusion: Epidural spinal cord stimulation (SCS) has the potential to improve motor function and restore locomotion in individuals with spinal cord injury from SCD. Key words: Case report, epidural spinal cord stimulation, spinal cord injury, subacute combined degeneration