How Lord Darzi’s review could pave way for better spinal injury care

Lord Darzi’s landmark NHS Review contains encouraging suggestions for spinal cord injury survivors – including its emphasis on integrating health and social care.

That is according to the Spinal Injuries Association (SIA), which has welcomed a number of points made in the report.

Lord Darzi, an independent peer and an NHS surgeon, published his NHS review this morning, stating his “shock” at some of his fundings; including the identification of “worrying health inequalities”.

The SIA said it was encouraged by the report’s recommendation to simplify the NHS through the creation of health and care authorities that will integrate services and focus on local needs.

It said in a statement: “For those living with SCI, fragmented care pathways often lead to delayed access to essential treatments and rehabilitation services. A more streamlined, coordinated system could significantly improve these outcomes, ensuring patients receive timely, personalised care.

“Moreover, the call to double social care funding by 2030 is critical for improving home care and support services for people with SCI, many of whom rely on a comprehensive care network to maintain their independence. SIA has always campaigned for a better-funded and more equitable social care system, and this recommendation is a step in the right direction.”

Lord Darzi’s report also highlights the growing mental health crisis in the NHS, with a particular rise in mental health issues following the COVID-19 pandemic.

The SIA said: “This is especially concerning for people with spinal cord injuries, who often face unique psychological challenges following the life-changing injury. Recent findings from SIA’s What Matters survey shows that 63 per cent of people with SCI experience anxiety or depression, exacerbated by a lack of specialised mental health services. These are even more exacerbated when it comes to people from other communities, where culture sensitive mental health services are also absent.

“While the report acknowledges the need to tackle the surge in mental health referrals, particularly among those with long-term conditions, it is essential that specific focus is also placed on the SCI community. There is a clear need for dedicated mental health support tailored to the complex needs of those adjusting to life with a spinal cord injury, where both the physical and emotional impact is profound.”

The charity also supports Lord Darzi’s call for embracing new technologies to empower patients and improve care delivery.

It urged decision-makers, however, to “ensure that technological advances remain fully accessible to individuals with disabilities. Innovative solutions must not only address specific physical health needs but also incorporate mental health and emotional well-being.”

It added: “The SIA is committed to working with the government and NHS leaders to ensure that the SCI community’s needs are fully represented in the coming reforms. Whilst we recognise that change cannot happen in a day, we urge swift implementation of Lord Darzi’s recommendations on social care funding, mental health, and integration of services, as these are vital to improving the quality of life for people with long term conditions, including those in the SCI community.

“We look forward to contributing to the development of a 10-year plan that ensures every person living with a spinal cord injury has access to the care, mental health support, and rehabilitation services they deserve.”

Dharshana Sridhar, campaigns manager at SIA, said: “Lord Darzi’s report paints a painful picture of the current state of the NHS, highlighting its deep-rooted challenges, from record waiting times to an escalating mental health crisis. For people with spinal cord injuries, who already struggle with delayed access to care and inadequate mental health support, these findings resonate painfully.

“The government now has an early opportunity to act on these urgent recommendations, particularly around social care funding and healthcare integration, to restore the NHS to proper functioning. This is a pivotal moment to ensure the system works for everyone, including those living with spinal injuries.

“We look forward to working with the Government and the NHS to ensure the recommendations from Lord Darzi’s report lead to tangible improvements in care and support.”

Researchers believe they have made a major breakthrough in the search for treatments for the rare neurological condition, Acute Flaccid Myelitis.

A new study demonstrates that a combination of transcutaneous spinal cord stimulation (TSS) and movement training can help children with AFM improve their ability to walk.

TSS is a non-invasive therapy where electrical current is applied through pads placed on the skin to the spine. It amplifies the volume on signals traveling from the brain through the spinal cord, facilitating muscle activation and restoring motor function.

The study involved four children with spinal cord injuries caused by AFM. Over a series of 22 therapy sessions, the patients received TSS while moving on a treadmill as part of their body weight was supported by a harness system.

The results were promising—three children showed improvements in walking distance, and two had measurable gains in posture, speed, and overall walking function.

Primary investigator Rebecca Martin, of the Kennedy Krieger Institute’s International Center for Spinal Cord Injury, said the research shows TSS is a safe, effective intervention that offers a new path for rehabilitation and improved quality of life.

“It’s encouraging to witness the transformations in these children,” said Martin. “TSS is revolutionising the field of neurorehabilitation, providing a safe alternative to the aggressive surgeries often required for young patients.”

AFM typically follows a viral infection and inflames the spinal cord, leaving children with long-term paralysis in their diaphragm, arms and/or legs.

According to the Centers for Disease Control and Prevention, AFM affects approximately one in 1 million children in the United States each year. Because it is so rare, it is often challenging for researchers to gather large sample sizes necessary for comprehensive studies. The research at Kennedy Krieger offers hope to families who often have limited options.

“This treatment is giving families a long-awaited solution when they previously had no answers,” said Martin.

“Now our goal is to continue refining this approach and make it more widely available to these rare patients across the country.”

Spinal Cord Stimulation device with AI tech receives certification in Europe

Nevro, a global medical device company delivering solutions for the treatment of chronic pain, has received CE Mark Certification in Europe for its HFX iQ spinal cord stimulation (SCS) system. The CE marking allows Nevro to market HFX iQ in all countries that recognise this certification.

HFX iQ is the first and only SCS system with artificial intelligence (AI) technology that combines high-frequency (10 kHz) therapy built on landmark evidence that uses ongoing cloud data insights to deliver personalised pain relief.

“We are thrilled to receive the CE Mark Certification for HFX iQ as it marks an important milestone in our strategic path to drive market penetration through our data-backed, AI-powered SCS therapy,” said Kevin Thornal, Nevro’s CEO and president.

“Patients in Europe suffering from chronic pain will now have access to personalised pain relief – and will be able to maintain that pain relief over time.”

“HFX iQ represents a transformative advancement in how we approach chronic pain management,” said Dr. Ganesan Baranidharan, anaesthesia and pain management consultant at Leeds Teaching Hospital NHS Trust.

“By leveraging AI technology and data-driven programming – developed using over 10 years of outcomes and real-world patient data – HFX iQ has the potential to not only help optimise healthcare resources through reduced in-person programming and unnecessary hospital visits, but it also sets new standards for earlier and effective pain management along with patient engagement in spinal cord stimulation.”

HFX iQ is digitally enabled and designed to optimise care by collecting patient data and guiding the patient through a personalised treatment pathway. It provides several key advantages over other SCS systems, including:

● Indication-specific HFX Algorithms™ for back and leg pain, non-surgical refractory back pain, painful diabetic neuropathy, chronic upper limb and neck pain.

● Customised therapy adjustment recommendations informed by patient inputs on the HFX App.

● The only 10 kHz Therapy that has CE-marked labelling for all major SCS indications and outcomes beyond pain relief.

“With HFX iQ, we are entering a new era of patient-centred pain management,” said Professor Faycal El Majdoub, head of Stereotaxy and Functional Neurosurgery at Cologne-Merheim Medical Center.

“The technology’s responsiveness to individual pain levels and real-time adaptation to patient needs means empowering patients in their pain relief journey.

“Patients experience an enhanced quality of life with few interruptions, allowing them to reclaim their lives with confidence and with less dependence on clinical interventions. HFX iQ is truly redefining what is possible for long-term pain relief.”

HFX iQ starts patients on the program most likely to provide pain relief, based on the HFX Algorithm™, which was built from more than 20 million data points and 80,000 implanted patients.

HFX iQ combines clinical inputs, such as pain relief and pain score, along with Quality of Life (QoL) inputs, such as pain medication and activity level changes, to provide an individualised program setting for each patient.

HFX iQ has the ability to program both low frequency and Nevro’s proprietary 10 kHz Therapy, which represents the widest range of frequencies of any SCS system on the market.

The Senza HFX iQ system is comprised of the HFX iQ Implantable Pulse Generator (IPG), HFX Trial Stimulator and HFX App. With a new Bluetooth-enabled IPG that is upgradeable and connects directly to the HFX App, each patient can input assessments into their smartphone and then receive programming adjustments in real-time.

In addition to receiving CE marking, HFX iQ received U.S. Food and Drug Administration (FDA) approval in 2022. Nevro will offer the HFX iQ system in select European countries starting in the first quarter of 2025.

New findings on neuromodulation in high-level spinal cord injury

Kessler Foundation researchers have published new findings on neuromodulation in individuals with high-level spinal cord injury (SCI) using spinal cord transcutaneous stimulation (scTS).

The promising approach to enhance cardiovascular regulation addresses the challenges of unstable blood pressure and the accompanying hypotensive and hypertensive events following SCI.

The findings revealed that in individuals with low blood pressure following a SCI, scTS at the lumbosacral vertebrae region was able to significantly elevate blood pressure, unlike cervical or upper thoracic stimulation.

This trend, consistent across eight participants in the case series, highlights the potential for scTS to be used as a non-invasive therapeutic intervention to regulate cardiovascular function in SCI patients.

Kessler Foundation authors included Einat Engel-Haber, MD, Akhil Bheemreddy, Mehmed B. Bayram, PhD, Manikandan Ravi, Fan Zhang, PhD, Steven Kirshblum, MD, and Gail F. Forrest, PhD, in addition to Haiyan Su, PhD, School of Computing, Montclair State University.

While scTS may offer flexibility in stimulation locations, as opposed to epidural stimulation – another common method of spinal cord stimulation – it also leads to significant variability and lack of validation in stimulation sites used by studies.

“In individuals with high thoracic or cervical SCI, blood pressure instability can limit daily activities and lead to short- and long-term health complications. Choosing the most suitable stimulation sites plays a key role in enhancing cardiovascular control in these patients,” explained lead author Dr. Einat Engel-Haber, associate research scientist in the Tim and Caroline Reynolds Center for Spinal Stimulation, the Foundation Center that supported the study.

“The research highlights the potential for developing new therapeutic options to address cardiovascular instability in individuals with SCI, a common challenge for this population,” she added.

“These findings open up avenues for further studies on how scTS can improve quality of life for those living with spinal cord injury and offer valuable insights for clinicians and researchers aiming to develop personalized stimulation protocols that target cardiovascular function in individuals with SCI,” concluded Dr. Engel-Haber.