Upper limb functional improvement associated with low-thoracic spinal cord stimulation and intensive rehabilitation after traumatic cervical spinal cord injury: A case report

Upper-limb effects of low thoracic spinal cord stimulation (SCS) remain unclear. A 45-year-old man with traumatic C5 spinal cord injury underwent epidural SCS at the T11 vertebral level 9 months after injury while undergoing an unchanged intensive rehabilitation program. After one month, his pain rating decreased from 8 to 3, bowel regularity and sweating improved, and proximal upper-limb strength and gross functional-task ratings increased. Grip became measurable at 3 months. With stimulation, median-nerve somatosensory evoked potentials showed residual but abnormal conduction, and cortical waveforms were modestly clear. These uncontrolled observations suggest a possible neuromodulatory interaction but do not establish causality.