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Roughly 300,000 people in the United States have suffered spinal cord injuries, life-changing events with far reaching-effects.
But, as William Brangham reports, new research out of the University of Louisville is giving dozens of paralyzed people the prospect of regaining some of what they have lost.
It's part of our series Breakthroughs on the Leading Edge of science.
For the last 10 years, this is the only way Kent Stephenson has been able to get around. He has a severe spinal cord injury, no feeling or movement below his chest.
So, what you're about to see is something that shouldn't be possible, because doctors told him his legs would never work again. And yet, today, he's back on his feet, struggling and straining to relearn how to take steps again.
Let's back up. In 2009, Stephenson was a semi-pro motocross rider. But one day at practice, he took a jump, his bike seized up, and he crashed. As he was rolled into the hospital on a gurney, he got a glimpse of a future he'd never imagined.
Opened my eyes, and you could see the ceiling, and it was metal, and you could see the reflection of myself.
And that was when it really hit me, because one of my boots was still on for some reason. I don't know why they didn't take it off, but I was like, oh, boy, I cannot feel that.
Stephenson had destroyed two vertebrae in his back. Doctors said he'd be in a wheelchair for the rest of his life. His career was over.
I mean, that was my dream since I was little, was to go do that, race that pro circuit and do all that. And it was — I mean, it was like, heck, yes, let's go, because everything was in place, and then everything changed that day.
But, in 2010, he enlisted in an experimental research program at the University of Louisville.
The traditional view has been that when someone like Stephenson has such a bad injury, the signal between his brain and his spinal cord is permanently severed.
But Susan Harkema — that's her in red — directs spinal cord injury research at the University of Louisville and the Frazier Rehab Institute. She wondered whether there was more to it than that.
When a person has a spinal cord injury, as devastating as that is, it's only where the bone is broken that the neurons die.
But there's millions of neurons below that are still alive and can function under the right conditions. And then we know all the neurons in the brain are still there. It's just that communication network that's broken.
Harkema and her colleagues ran a series of experiments using what's known as an epidural stimulator, a device typically used to treat pain.
Implanted near the base of the spine, it delivers a small electrical current. They wanted to test the idea that this current could restore some of that spinal communication.
But when Stephenson got his implant, he thought the whole thing sounded pretty far-fetched.
I know, the whole time, you're just thinking, like, come on, guys, we know what the answer of this is.
It ain't going to happen.
You know, the little gremlin over here on my shoulder, yes, he's like, what are you — you're wasting your time.
That was, until something remarkable started to happen. This video is from 2011. That's Stephenson there. He'd just had his stimulator implanted.
Remember, he hadn't moved his lower body in years. But now he's going to try.
Oh, man, I mean, it was — my mom was in the room. And I was there. We got all eye-watery and everything. I mean, I was like, oh, boy, you know, now what? Where's this going to go, you know?
Because I have just been told from day one that you just traumatically injured your spinal cord. It's done. You know, there's nothing.
Harkema acknowledges she too was stunned at these results. She and her colleagues don't exactly know how or why this all works.
The theory is, even with the most severe spinal injuries, some pathways remain intact, and the stimulator helps amplify the signal from the brain through the spine to the limbs.
Then, to augment this effect, they use intense physical therapy to recreate what it physically and mentally feels like to walk again.
You put weight back on the legs, you get them extended, you get the trunk upright, and the spinal circuitry says, oh, I know what that is. That's standing. I know how to do that.
And then the circuits for standing relearn again.
Nearly two dozen others have been implanted with stimulators through this program. Twelve are now able to stand upright with support. Two have been able to walk assisted over flat ground. One managed to walk nearly a quarter-of-a-mile, with breaks, over the course of an hour.
Other programs in Switzerland and the Mayo Clinic in Minnesota have produced similar results. Of course, it's all easier said than done. Training, in many cases, takes more than a year.
Marissa Kirkling has had her implant since last summer. After a car accident last year left her paralyzed below the chest, she too had been told this would never happen.
One, two, three.
She's in the early days of learning to stand again. And she's the first to admit it's really hard.
You have to be thinking. As I keep talking, I kind of get a little off — focused off my legs. I'm losing them.
So, am I distracting you here? Should I go away?
No, you're OK.
She's got to concentrate on every single muscle, her posture, where her feet are, not to mention answer my questions.
Before my accident, you know, you don't have to really think. Like, you're standing there right now. You don't have to think, oh, squeeze your glutes, toes up, heels to the floor.
So, you're thinking all those thoughts right now?
Yes. I am, like head up straight, neck back, shoulders back, yes, so — because if you don't think about them, you're going to — I'm going to buckle.
But the benefits for her go beyond standing. Spinal cord injuries also impair some people's ability to regulate their blood pressure.
Kirkling says hers would drop so suddenly, even getting out of bed was a challenge.
Then you pass out, and then it's like you're out, and then you just come back. And then you just have to try again.
And that would happen several times during an average day?
Yes. Yes. It's just — you could be at the grocery store or the mall shopping, just sitting there watching a movie. It doesn't matter.
But the epidural stimulator also improves this function.
Now Kirkling is off most of her blood pressure medications, and she can get through most days without passing out. She's also regaining her ability to sing, something else her accident robbed her of.
Of course, there are still plenty of other open questions.
Dr. Ali Rezai is a neurosurgeon and director of the Rockefeller Neuroscience Institute at West Virginia University.
It's interesting and it's exciting, but there's a lot of constraints that we need to look at, in terms of, not every — it doesn't work in everybody.
So we have got to understand, why is it? I think being able to just get rough movements is very exciting, no doubt, but we need to translate that into functional, practical applications.
Beyond that, Rezai says, there's the issue of scalability.
A lot of these studies across the world have large teams, neurosurgeons, neuroscientists, neurologists, dozens of people. And the patients have to come to the hospital or to the clinic. We need to translate that to the home.
Harkema acknowledges this research is still just the tip of the iceberg.
We need to look at the process differently right now. Regardless of epidural stimulation, whether it should be a treatment or not, we know people can recover. I mean, that's clear.
For Kent Stephenson and his wife, who were babysitting their niece when we visited, it's meant dreams of an expanding future.
One of my questions right out of the gate in the back of my mind was, can I have kids?
You know, the physical fitness that I have gotten back from being part of the stimulator program, it gives me that instillment that I could be, you know, the utmost father that I was going to be before or after injury.
For Marissa Kirkling, it not only means the possibility of one day standing and walking on her own, but regaining the ability to do something she loves.
For the "PBS NewsHour," I'm William Brangham in Louisville, Kentucky.
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William Brangham is a correspondent and producer for PBS NewsHour in Washington, D.C. He joined the flagship PBS program in 2015, after spending two years with PBS NewsHour Weekend in New York City.
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