'A remarkable era': Groundbreaking innovations in treating spinal cord injury offer new hope for patients

Gert-Jan Oskam could no longer walk after a cycling accident 12 years ago in China.

He suffered an incomplete spinal cord injury, so while he had some sensation in his lower body, he used a wheelchair after he returned home to the Netherlands. 

But he wanted to be able to stand.

That's why Oskam, 40, agreed to be one of three participants in a Swiss pilot study of an experimental brain implant in 2017.

The implant would allow him not just to stand, but to walk. When he pressed a button, a processor worn in a backpack would analyze his brain signals to try to activate his leg muscles for walking.

It worked, but not completely — his gait was stiff and robotic, and his steps were delayed because they were automated.

Then a few years later, the researchers recruited Oskam to "test pilot" an upgraded implant system that would translate his thoughts into motion. When he thought about walking, electronic implants on his skull would pick up his brain signals, register them as instructions to move his legs, and send them to the corresponding muscles through another implant on his spine.

"You're creating a sort of digital bridge" between the brain and spinal cord, said Canadian neurosurgeon Jordan Squair. Squair treats spinal cord injuries at the Swiss Federal Institute of Technology in Lausanne, Switzerland, where work on Oskam's implant is based.

In May, the researchers reported on Oskam's progress more than a year into the study. His walking is now fluid. He can climb stairs and handle rough terrain; he can walk faster and farther; and he's able to use the technology outside the lab at his home.

"The stimulation before was controlling me, and now I'm controlling the stimulation," Oskam said in a media briefing.

In 2024, medical researchers plan a pivotal clinical trial to test the safety of the implant in more subjects. Their goal is to miniaturize the system and make the technology available worldwide.

Oskam's progress and other advances in treatment of spinal cord injury — including a pioneering type of microsurgery that's now being performed in Toronto — signal a promising turning point for the field.

In Canada, more than 86,000 people live with spinal cord injury, according to Praxis Spinal Cord Institute (formerly the Rick Hansen Institute). Doctors say about half to two-thirds of those are incomplete injuries like Oskam's.

Squair said linking spinal cord stimulation to help people walk better by decoding their thoughts, as Oskam's implant does, is a true technological step forward.