PMC7593242_01
Site of implantation of the electrode array and stimulating configuration for cardiovascular stability-spinal cord epidural stimulation (CV-scES). (A) Sagittal and Axial MRI sections of the lumbosacral cord were used to calculate the cross-sectional area of the spinal cord and cerebrospinal fluid to create a 3-D reconstruction of the spinal cord at the lumbosacral enlargement. (B) Sagittal x-rays indicating the final placement of the electrode array. (C) 3-D reconstruction of the electrode array relative to the lumbosacral enlargement. (D) Graphical representation of electrode configuration for CV-scES, configuration uses two programs (P1 and P2) running concurrently. Cathodes are represented in black and anodes in gray. Each program runs with an independent stimulating amplitude, pulse width, and frequency.
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F1
One individual (female, 26.9 years old, 3.1 years from initial SCI) with chronic cervical motor-complete (C4, AIS grade A) SCI who presented with significant cardiovascular dysfunction was implanted with a 16-electrode array epidural stimulator (RestoreAdvanced, Medtronic) on the dura between spinal segments L1-S1 at the T11-L1 vertebral level (Figure 1). Parameters for CV-scES, including electrode polarity, frequency, and pulse width (Figure 1), were optimized to maintain systolic blood pressure within a normative range of 110-120 mmHg (Figure 1) without eliciting lower extremity or core muscle activation (Figure 1).