2022年经济学人 脊椎植入物可以让瘫痪者再次行走（在线收听）

Science & Technology

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Neurology

神经学

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Spinal implants allow the paralysed to walk, swim and cycle again

脊椎植入物可以让瘫痪者再次行走、游泳和骑车

Four years ago Michel Roccati was involved in a motorcycle accident.

四年前，米歇尔·罗卡蒂(Michel Roccati)遭受了一场摩托车事故。

He suffered what neurologists call a "complete" spinal-cord injury—he lost all sensation below the site of the damage to his spine and he could no longer move his legs.

他遭受了神经学家所说的“完全”脊髓损伤——脊椎损伤部位以下完全失去知觉，双腿也不能动了。

In December last year, however, the young Italian stood up on the streets of Lausanne, Switzerland, and took a short walk.

然而，去年12月，这位年轻的意大利人站在瑞士洛桑的街道上，走了一小段路。

Mr Roccati's remarkable steps, supported by a wheeled walking frame, were the conclusion of more than a decade of work by Grégoire Courtine, a neuroscientist at the Federal Institute of Technology in Lausanne, and Jocelyne Bloch, a neurosurgeon at Lausanne University Hospital.

在轮式行走支架的支撑下，罗卡蒂迈出了惊人的步伐，这是洛桑联邦理工学院神经科学家格雷瓜尔·库尔廷(Grégoire Courtle)和洛桑大学医院(Lausanne University Hospital)神经外科医生乔斯琳·布洛赫(Jocelyne Bloch)十多年的研究成果。

The scientists had fitted Mr Roccati with a device that stimulated nerves in his back that once controlled muscles in his lower body and legs, but which had lain dormant since his accident.

科学家们在罗卡蒂先生身上安装了一种刺激背部神经的装置，这些神经曾经控制他下半身和腿部的肌肉，但自从他发生事故后就一直处于休眠状态。

Even after a severe spinal injury, the nerves that control activities such as walking often remain intact below any damaged tissue.

即使在严重的脊椎损伤之后，控制行走等活动的神经通常都保持完好。

In people with paralysis, however, the damaged tissue interrupts or weakens any electrical signals coming from the brain.

然而，对于瘫痪的人来说，受损的组织会中断或减弱来自大脑的任何电信号。

Dr Courtine and Dr Bloch developed a wafer-thin device with electrodes that could target the dormant nerves.

库尔廷博士和布洛赫博士开发了一种极薄的设备，其电极可以瞄准休眠的神经。

Once implanted into Mr Roccati's back, the device sent in pulses of electricity that mimicked those normally present in the nerves of an uninjured person as they walk.

一旦植入罗卡蒂先生的背部，这种装置就会发出电脉冲，模拟正常的人行走时神经中通常存在的电脉冲。

By doing this, the device acted like an amplifier for any electrical signals coming from Mr Roccati's brain.

通过这样做，该设备就像是一个放大器，可以接收来自罗卡蒂大脑的任何电信号。

Those signals would normally be blocked by his damaged spinal tissue and be incapable of activating the nerves in his lower back.

在正常情况下，这些信号通常会被他受损的脊椎组织阻挡，无法激活他背部下部的神经。

But with the stimulation device in place, Mr Roccati was able to voluntarily control those once-dormant nerves, allowing him to move his legs and walk.

但有了刺激装置，罗卡蒂就能够自主控制那些曾经休眠的神经，让他能够移动双腿和行走。

Mr Roccati was one of three paralysed volunteers who took part in a small clinical trial of the device, details of which were published this week in the journal Nature Medicine.

罗卡蒂是参与该设备小型临床试验的三名瘫痪志愿者之一，该试验的细节本周发表在《自然医学》杂志上。

The device worked well enough that all three users in the trial were able to stand up and take a few steps almost immediately after they had recovered from the surgery to have it implanted.

该设备运行良好，试验中的三名用户在植入手术恢复后几乎都能立即站起来走几步。

This was a marked improvement on previous implementations of this kind of technology, in which scientists had repurposed nerve implants normally used to treat chronic pain.

这与之前这种技术的实施相比是一个显著的进步，科学家们重新调整了通常用于治疗慢性疼痛的神经植入物。

In the few instances where those experiments had been successful, it had taken many months of training for patients to learn to walk again.

在少数几个实验成功的案例中，患者需要经过数月的训练才能重新学会走路。

Dr Courtine's and Dr Bloch's new device can be configured to fire its electrical impulses in many different patterns, each of which corresponds to a different activity.

库尔廷博士和布洛赫博士的新设备可以配置成以许多不同的模式发射电脉冲，每种模式都对应于不同的活动。

Patients in the trial were not only able to stand and walk, but eventually also to swim and cycle.

试验中的患者不仅能站立和行走，而且最终还能游泳和骑自行车。

The new device will need approval from medical regulators before it can be used in clinics.

这种新设备需要获得医疗监管机构的批准，才能在临床上使用。

Its inventors set up a company called NeuroRestore, which is working with Onward Medical, a Dutch company, to commercialise their new device.

它的发明者成立了一家名为NeuroRestore的公司，该公司正与荷兰公司Onward Medical合作，将他们的新设备商业化。

The impact of the device on the lives of those in the small Swiss trial, however, has already been dramatic.

然而，在瑞士进行的小规模试验中，该设备对那些患者的生活产生了巨大的影响。

Mr Roccati highlights the little things — walking up stairs, for example, or standing in the shower.

罗卡蒂先生强调了一些小事——比如，走上楼梯，或者站着淋浴。

At a bar, he can stand up to chat with friends.

在酒吧里，他可以站起来和朋友聊天。

After training, he is now also able to walk around for two hours every day.

经过训练，他现在也可以每天走两个小时了。

"With the walker," he says. "I am free."

“用助行器，”他说。“我是自由的。”