Abstract:

Central paralysis is caused by damage to motor conduction pathways in the brain or spinal cord， most commonly due to stroke or spinal cord injury. It often results in motor dysfunction，spasticity， and sensory abnormalities， severely impairing patients' quality of life and imposing a substantial societal burden. In recent years， neuromodulation techniques， particularly spinal cord stimulation （SCS）， have attracted increasing attention due to their minimally invasive and reversible nature. SCS delivers electrical pulses to the dorsal spinal cord via epidural electrodes， thereby reducing muscle tone， alleviating spasticity and pain， and promoting motor recovery. Its therapeutic mechanisms involve modulation of neural plasticity， sensory afferent input， excitability of spinal motor neurons， and neurotransmitter release. Compared with traditional surgery and other neuromodulation approaches， SCS offers non-destructive， direct action with a wide range of potential benefits， including improvements in consciousness and autonomic dysfunction. Future development of SCS is expected to incorporate multichannel electrodes， intelligent algorithms， closed-loop control， and robot-assisted rehabilitation，enhancing both precision and efficacy. This article reviews the current situation， surgical indications and contraindications， surgical methods， postoperative management and therapeutic outcomes of SCS in the treatment of central paralysis.

Key words: Central paralysis, Spinal cord stimulation, Stroke, Spinal cord injury, Neuromodulation