For people living with spinal cord injuries, something as simple as sitting up in bed or moving into a wheelchair can be dangerous.
Sudden drops or spikes in blood pressure are common after such injuries, leaving patients at risk of fainting, stroke, or heart attack.
Now, an international research team has developed an implantable neurostimulation system that may finally offer a solution.
The device is being tested in clinical trials led by researchers at the University of Calgary in Canada, École Polytechnique Fédérale de Lausanne (EPFL) and University of Lausanne (UNIL) in Switzerland, and Sint Maartenskliniek and Radboudumc in the Netherlands.
The early results have been groundbreaking, giving participants—including 32-year-old spinal cord injury survivor Cody Krebs—new stability and independence.
Krebs was injured in a car accident in 2022 and has used a wheelchair since then.
The injury damaged his spinal cord, preventing his brain from properly controlling his blood pressure. Simple activities, like transferring from bed to chair, could cause his blood pressure to plummet, leaving him on the verge of passing out.
At other times, nerve pain triggered sudden spikes, causing migraines and sweating. “Just getting through the day was a challenge,” Krebs explained. “Now, I feel like I finally have some control again.”
The implant works through a new class of electrode arrays placed on the spinal cord. These are connected to a pulse generator—similar to a heart pacemaker—that delivers carefully tuned electrical stimulation.
Each system is calibrated to the individual and can be adjusted through an app. Once activated, the device restores blood pressure to a safe, functional range, often within minutes.
The therapy is based on years of research into the neural pathways that control blood pressure.
In landmark papers published in Nature and Nature Medicine, the scientists mapped the spinal circuits responsible for both low blood pressure and life-threatening spikes, known as autonomic dysreflexia.
By targeting these circuits with stimulation, they were able to stabilize blood pressure across 14 participants in multiple countries.
“This is more than a proof of concept,” said Dr. Aaron Phillips of the University of Calgary, one of the study leaders. “We’ve shown that neuromodulation can be applied safely and effectively in different clinical environments with consistent results.”
Participants reported major improvements in daily life. They experienced less brain fog, more energy, and greater mental clarity. Some could speak louder and no longer struggled with severe dips in blood pressure after meals. Importantly, the surgery proved straightforward, since similar devices are already widely implanted for pain management.
Neurosurgeon Dr. Jocelyne Bloch of UNIL said the international success of the trials shows the system can be safely deployed regardless of local medical practices. “This is a major milestone toward making the technology available to patients everywhere,” she noted.
While most spinal cord injury research has focused on restoring movement, many patients suffer more from chronic low blood pressure, which leaves them fatigued and vulnerable to long-term cardiovascular problems. This new therapy directly addresses that need.
The system, developed by ONWARD Medical, has already received FDA approval to begin a larger pivotal trial at research centers across Canada, Europe, and the United States. For participants like Krebs, the future looks brighter.
“I have more energy and I’m thinking more clearly,” he said. “It feels good to finally have control over something I lost after my injury.”
