A Humboldt Broncos player paralyzed in last year’s bus crash is taking his first assisted steps after getting an epidural stimulation implant embedded in his spine.
Ryan Straschnitzki travelled to Thailand for surgery to get the implant in early November.
Now, the 20-year-old is beginning to walk, according to a video his father Tom posted to Twitter.
In the video, Straschnitzki walks with the help of a wheeled walker, with a therapist watching his knees and ankles to ensure that they don’t buckle.
“There’s so much potential and there’s so many opportunities with a procedure such as this,” said physiotherapist Uyen Nguyen, executive director of Calgary’s Synaptic Spinal Cord Injury and Neuro Rehabilitation Centre, where Straschnitzki is receiving treatment.
The device works by “amplifying the message” to help re-connect the brain and the body, she said. It’s not a cure and won’t make people able to walk unassisted again, but she would like it to be more available.
“Absolutely, we would like this to be here in Canada and accessible to our patients here at home,” she said.
The implant is an experimental device and isn’t licensed for use for spinal cord injury in Canada. According to Health Canada, no manufacturer has applied yet for approval.
“Health Canada has licensed spinal cord stimulators for pain relief,” the department wrote in a statement. “However, the Department has not licensed a spinal cord stimulator device for regaining motor skills or sensory functions following spinal injuries, nor received an application for this intended use as of yet.
“It is up to companies to submit applications to Health Canada before their health product (e.g., medical device) can be sold in Canada. Approval from the Department would also need to be sought for a new intended use of an already approved medical device.”
But it’s increasingly being looked at around the world.
Dr. David Darrow, chief resident at the University of Minnesota’s neurosurgery department, is currently running a clinical trial looking at the device. As of last week, he had implanted 12 patients, with two more scheduled for this week.
“It’s exciting because we have seen, so far, a really good response,” he said. “We’ve seen nearly everyone have immediate restoration of some movement.”
“Right after we put the implant in, we turn it on, and all of a sudden they seem to have some control over their legs.”
Patients with this type of complete spinal cord injury not only lose the ability to move their legs, he said, but also have problems with sensation, with urinary and bowel function, and sexual function. Patients also often have trouble with low blood pressure, which can sap their energy throughout the day.
The trick, he said, is to properly calibrate the devices. They have billions of different settings, he said, and they can all be tweaked to adjust how they affect the different problems. His research is focusing on figuring out which settings can help each patient’s unique issues.
“We have to develop a neuro modulation platform like spinal cord stimulation that helps everyone in a way that we understand well enough to be able to tell patients, ‘This is what we think is going to happen if you do this.’”
Only about 30 patients worldwide have gotten the implants as part of a clinical trial for spinal cord injury, he said, though it’s hard to know how many people have gotten them outside of registered trials, in places like Thailand.
One of those is Dr. Richdeep Gill, a Calgary surgeon, who broke his neck a year and half ago while boogie-boarding in Hawaii. His spinal cord was severed and he lost motor control from his chest down.
He researched treatment options while recovering in hospital and chose to go to Thailand for a surgery, where the procedure costs $80-90,000 out-of-pocket. He was relatively confident the procedure was safe, he said, because the implant is approved for pain control in Canada and the U.S., even if it’s not approved to treat spinal cord injury.
He quickly noticed results. “It allows you to initiate movements within your legs. So, things like assisted standing, assisted stepping,” he said.
“The key thing to remember, I think, is that it’s not a cure. Getting to a place where you’re independently walking is still a long ways away.”
He uses the device most of the day to help regulate his blood pressure and reduce spasms, and has been able to use it to stand for a time. The technology, he said, is in its early days: “This is like the Atari version. You really need the Xbox version of the device.”
As the technology improves, he said, he hopes that it will help people do more complicated movements with their legs and perhaps one day walk independently. He also hopes that someday it’s approved for spinal cord injury treatment in Canada.
Darrow said that research is continuing in that direction, but it’s not there yet.
“With less than 30 patients, that’s not very representative of the whole community at large. Just in the U.S., there’s more than 300,000 people with spinal cord injury.”
He’s excited about the progress to date though.
“All of a sudden, everything we knew about the spinal cord, somehow is turned on its head. That really unlocks the potential for all the other smart people — all the scientists and engineers — to join this conversation and really start to figure out how this works so we can move the field over it. I think it’s tremendously inspiring.”