Epidural versus Transcutaneous Spinal Cord Stimulation for Motor Recovery after Spinal Cord Injury: A Comparative Analysis

Spinal cord injury is a serious neurological condition that leads to loss of voluntary movement and reduced quality of life. Rehabilitation is the standard treatment, but it often fails to adequately restore motor function. Spinal cord stimulation (SCS) is a promising approach to improve motor function after injury. Two main types exist: epidural and transcutaneous stimulation. Clinical studies over the past two decades have demonstrated that both types of SCS, combined with rehabilitation, improve motor function. Epidural SCS functions as an assistive therapy that restores muscle activity and single joint movements within one week of implantation. Transcutaneous SCS is a long-term therapy with cumulative improvements observed over treatment periods of up to 18 weeks. Epidural SCS provided benefits to all participants regardless of injury severity, while transcutaneous SCS consistently helps only individuals with incomplete motor injuries.