Spinal cord injury (SCI) disrupts autonomic control, leading to cardiovascular, bowel, lower urinary tract (LUT), and sexual dysfunctions. Spinal cord stimulation (SCS) has shown therapeutic promise, but a comprehensive review of its effects on autonomic recovery after SCI has not been performed.
To synthesize evidence on the effects of SCS on autonomic functions, specifically cardiovascular, bowel, LUT, and sexual function, in animal models and individuals with SCI.
PubMed, EMBASE, and Web of Science; from date of inception to September 2025.
Studies were included if they investigated the effects of SCS on cardiovascular, bowel, LUT, or sexual function in humans or animals with SCI. Of 2079 studies screened, 68 met inclusion criteria: 15 animals, 50 humans, and 3 involving both species.
Data were independently extracted, and final inclusion decisions were reached by consensus among authors.
Both animal and human studies show that SCS enhances autonomic function after SCI. It improves bladder control, cardiovascular stability, and bowel motility in animals; and additionally alleviates neurogenic bowel symptoms, increases bladder capacity and compliance in humans. Improvements in sexual function were observed in both animal and human studies.
Evidence primarily comprises case reports, case series, and cohort studies, with few controlled trials. Mechanistic studies remain limited, and methodological heterogeneity restricts comparisons.
SCS shows promise in improving autonomic dysfunction after SCI and enhancing quality of life. These findings inform priority areas for RCTs and mechanistic studies to optimize protocols and patient selection.
Journal of neuroengineering and rehabilitation. 2026 Jun 12 [Epub ahead of print]
Vivek K Pandey, Marco Law, Chris Shamatutu, Karina C Martin, Manvir Taunk, Parag Gad, Tom E Nightingale, Zakari R Dymock, Andrei V Krassioukov, Rahul Sachdeva
Department of Physical Medicine & Rehabilitation, University of Kentucky, 2050 Versailles Road, Lexington, KY, 40504, USA., International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada., SpineX Inc, Los Angeles, CA, USA., School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK., International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada. ., Department of Physical Medicine & Rehabilitation, University of Kentucky, 2050 Versailles Road, Lexington, KY, 40504, USA. .