New Italian technique

Medicine: Four people with complete spinal cord injuries walk again

The new technique was developed through a collaboration between the Vita-Salute San Raffaele University in Milan and the Sant’Anna School of Advanced Studies in Pisa, and involves a slight voluntary extension of the trunk

by Pietro Menzani

8 September 2026

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3' min read

Translated by AI

Versione italiana

3' min read

Translated by AI

Versione italiana

After months of intensive rehabilitation, four young people who had been paralysed due to a complete and chronic spinal cord injury have regained the ability to walk. They had lost all control over their leg muscles, but now, albeit with the aid of a walking frame, they are able to get up from their wheelchairs and move about. This exceptional result has been made possible by a new Italian technique, developed in the Modular Implantable Neuroprostheses (MINE) laboratory, which was established through a collaboration between the Vita-Salute San Raffaele University in Milan and the Sant’Anna School of Advanced Studies in Pisa, and is based at the IRCCS San Raffaele Hospital.

The young people involved

This is the first time that this innovative technique, which researchers have named ‘Trunk-mediated control’ (Tmc), has been trialled. The first to benefit from it were four young Italians under the age of 35 – three men and one woman. Two are from Lombardy, one from the Marche region and one from Umbria. One of them, Nicolò, who will turn 21 in October, was a torchbearer at the opening ceremony of the Milan-Cortina Winter Paralympics.

Significant progress has been made. The WISCI II score, used to assess walking ability in people with spinal cord injuries, has improved for all participants from 0 to 9. Three of them have achieved the ability to stand for long periods using just one hand for support, whilst using the other for small everyday tasks. One of them even walked 132 metres in 42 minutes without stopping, and all of them managed to walk whilst negotiating bends, slopes and uneven outdoor surfaces.

The new technique

The process that has enabled the four patients to move their legs again is based on a commercially available spinal cord stimulator, which is activated by a slight extension of the trunk – on average, around nine degrees. This movement alters the response to stimulation and facilitates the transition from leg extension – necessary to support body weight – to the coordinated flexion of the hip, knee and ankle required to take a step.

Thanks to this strategy, therefore, it is the patient themselves who, through the movement of their torso, contributes voluntarily and immediately to controlling their movement. No brain implants, external sensors or decoding algorithms were therefore required. The details are set out in a study published in the journal Med-Cell Press.

The background to the study

The technique that has enabled the four patients to walk again is based on the hypothesis that movement of the torso temporarily alters the anatomical relationships between the nerve structures and the electrodes, thereby changing the effect of the stimulation. As noted by Pietro Mortini, director of the Neurosurgery and Gamma Knife Radiosurgery Unit at the IRCCS San Raffaele Hospital and full professor of neurosurgery at the Vita-Salute San Raffaele University, who led the research alongside Silvestro Micera, a professor of bioengineering at the Sant’Anna School of Advanced Studies, however, ‘we are not talking about a recovery of the ability to voluntarily contract the leg muscles: that ability remained absent in all four participants. Instead, we have found a way to utilise a preserved voluntary function – trunk movement – to control the effects of the stimulation and enable the person to actively participate in the formation of the step’.”

Sandro Iannaccone, head of the physiotherapists at the Mine Lab, emphasises that ‘the result stems from the integration of spinal cord stimulation with an innovative, intensive, progressive and personalised rehabilitation programme’. From a neuroengineering perspective, however, Micera explains, the key point “is that the body itself becomes part of the control interface. We do not need to decode a brain signal or add external sensors: we utilise the interaction between residual voluntary movement, the body’s biomechanics and stimulation of the nervous system to generate the command required for walking’.