SINGAPORE – Mr Sam Subian, 49, was a competitive jockey for 25 years until his horse Silver Spoon stumbled during training in June 2017, flinging him onto the track.
“Silver Spoon died and I fractured my spine. I could not sense anything below my chest. I was told I would never stand or walk again,” Mr Sam said.
It took him a few years to come to terms with not being able to walk, let alone compete, and he was worried about who would care for his mother.
But for the past seven months, Mr Sam has been able to walk unassisted, thanks to an implant that helps overcome the damage to the nerve pathways in his spinal cord – and lots of hard work.
He was the first of three participants in a new clinical trial here, called Restores (restoration of rehabilitative function with epidural spinal stimulation), that may spell hope for people who would otherwise never walk again.
Spinal cord damage disrupts the transmission of electric impulses or signals that control movement and sensation from the brain to parts of the body like the arms and legs, depending on where the damage is. These signals travel over nerve pathways.
The procedure involves implanting a spinal cord stimulator (SCS) – an electrode powered by a battery pack inserted into the lower back and connected to the covering of the spinal cord below the damaged area.
“The aim of the trial is to bridge the damaged part of the spinal cord and boost signals from the brain to the muscles by tapping on residual pathways that are still viable,” said neurosurgeon Wan Kai Rui from the National Neuroscience Institute (NNI).
The stronger signals can stimulate a person to walk again.
After the implant operation, participants undergo advanced robotic rehabilitation. The researchers study how this helps improve nerve and muscle functions in patients paralysed from the chest down.
The procedure is the first of its kind in the region, and is being trialled by NNI, Tan Tock Seng Hospital (TTSH) and the Agency for Science, Technology and Research (A*Star), with grants from the National Medical Research Council and the Ng Teng Fong Healthcare Innovation Programme.