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San Raffaele Hospital: World's First Case Study Demonstrates the Effectiveness of Spinal Cord Neurostimulation in a Paraplegic Patient with Severe Conus Medullaris Injury
This research builds on a path that began with the first implantation of a spinal cord neurostimulator in 2023, carried out by the neurosurgical team at IRCCS Ospedale San Raffaele led by Professor , Head of Neurosurgery at the hospital and Full Professor of Neurosurgery at Vita-Salute San Raffaele University. The path continued with the publication, in in 2025, of the first results from two implanted patients, demonstrating the .
"With this case study, we have shown for the first time the effectiveness of epidural electrical stimulation (EES) combined with rehabilitation in restoring lower limb motor functions in a paraplegic patient with a —enabling him to stand and walk short distances," explained , neurosurgeon and researcher at San Raffaele Hospital and first author of the study. "Beyond motor recovery, the stimulation also ."
"The results of this study," added Professor Pietro Mortini , "offer new hope to patients with , making previously unimaginable recovery possible through the integration of advanced neuromodulation and personalized rehabilitation."
is the terminal segment of the spinal cord, typically located between the first and second lumbar vertebrae (L1–L2). In this region , meaning injuries can impair lower limb motor and sensory functions as well as autonomic control of vital functions like urination, defecation, and sexual activity. Conus medullaris injuries often result from car accidents, falls, or violent trauma and account for involving the spinal cord-root junction.
The subject of the study is a 33-year-old man who suffered a severe spinal cord injury at the lower thoracic level (T11–T12) four years ago, resulting in paralysis of the lower limbs. Although classified as "incomplete" ( ASIA Grade C), the injury severely affected his mobility. Despite two intensive rehabilitation programs following the trauma, the patient remained unable to stand or walk. Tests also showed damage to the nerve roots connecting the spinal cord to the leg muscles (L4–S1), indicating involvement of both the central and peripheral nervous systems—making this a particularly challenging case to treat, as conventional therapies rarely succeed when neural circuits are impaired at multiple levels.
"We implanted a spinal stimulation system with 32 electrodes between T11 and L1," explained Professor Pietro Mortini . "Once activated, the stimulation re-engaged residual neural circuits, particularly those controlling trunk muscles and hip flexors—key for regaining posture and walking ability. After an initial calibration phase, the patient underwent an innovative rehabilitation program integrating virtual reality exercises using sensory and motor feedback."
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: iocammino@hsr.it
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