New implant restores blood pressure balance after spinal cord injury  Collaboration between Radboudumc and Sint Maartenskliniek in international study

17 September 2025

The Sint Maartenskliniek and Radboud university medical center have made a significant contribution to an international study on a new neurotechnological solution. This innovation targets a common and impactful consequence of spinal cord injury: chronically low blood pressure. The results of this study were recently published in Nature Medicine.

More than forty percent of people with a spinal cord injury suffer from low blood pressure. This can lead to fatigue, dizziness when standing up, nausea, fainting, and difficulty with focus and concentration. Due to the injury, the body can no longer properly regulate blood pressure and heart rate in response to daily activities. 

To address this often-invisible issue, researchers from Switzerland and Canada developed a treatment to restore blood pressure regulation in spinal cord injury patients. This treatment was transformed into an implantable spinal cord stimulation system. The system includes a specially designed pulse generator—a kind of pacemaker—that delivers electrical impulses. These impulses are precisely tailored to the patient’s needs and help maintain stable blood pressure. 

This new technology, developed in collaboration with ONWARD Medical, was tested on patients in Switzerland, Canada, and the Netherlands. Each team independently performed the implantation and follow-up care. In the Netherlands, the study took place in Nijmegen: the surgery (implantation) was performed at Radboudumc, and the measurements and rehabilitation were carried out at the Sint Maartenskliniek. 

Positive experiences in Nijmegen 

Rehabilitation physician Ilse van Nes from the Sint Maartenskliniek, also lead researcher of the Nijmegen study, explains: 'Disrupted blood pressure regulation after a spinal cord injury is an underexposed issue, even though it has a major impact on patients. Many treatments focus on restoring movement, but really, you want to first stabilize basic functions like blood pressure. Until now, we didn’t have good treatment options for this. Fortunately, this study offers a lot of hope. We observed that blood pressure returned to normal within minutes of activating the system. Patients reported less ‘brain fog,’ more energy, stronger voices, and fewer post-meal dips. It also improved their sense of independence.' 

Spinal cord injury patient Sjors, a participant in the study, quickly noticed the benefits: 'What struck me immediately was that I could breathe better. My heart rate dropped, and my body didn’t have to work as hard. The stimulation also helps me sit more upright, which reduces neck and back pain.' Thanks to the neurostimulation, he feels more energetic and is able to do more—and for longer. Sjors adds: 'I don’t have to skip as many things anymore. That’s the biggest win for me.' 

Neurosurgeon Erkan Kurt from Radboudumc performs the neurostimulation implantations. He explains: 'The results are very promising. In most patients, blood pressure stabilizes shortly after implantation, which benefits their overall health and independence. As a neurosurgeon, it’s remarkable to see how this technology can truly improve the daily lives of people living with the effects of low blood pressure after a spinal cord injury.'

In this picture: Ilse van Nes (l) and Erkan Kurt (m).

Towards broader application

'The international implementation shows that the treatment is safe and effective, regardless of local practice differences. That’s an important step toward broad availability,' says Swiss neurosurgeon Prof. Jocelyne Bloch (CHUV/UNIL), who led the groundbreaking research together with Prof. Grégoire Courtine (EPFL) and Dr. Aaron Phillips (UCalgary). By the end of 2025, ONWARD Medical will launch a follow-up study to gather sufficient evidence for approval and reimbursement. This greatly increases the chances that the therapy will become available to everyone who needs it. 

That would be great news for Sjors and many other spinal cord injury patients. Sjors is eager to continue with the neurostimulation: 'The ‘pacemaker’ lasts about five to six years. After that, it needs to be replaced. Right now, it’s not covered by insurance. Hopefully, that will change in the future, because neurostimulation has brought me so many benefits.'

About this publication 

This article appears in Nature Medicine: The implantable system that restores hemodynamic stability after spinal cord injury Aaron A. Phillips, Aasta P. Gandhi, Nicolas Hankov, Sergio D. Hernandez-Charpak [...] Erkan Kurt, Steve Casha, Fady Girgis, Ilse van Nes [...], Léonie Asboth, Jordan W. Squair, Jocelyne Bloch and Grégoire Courtine. DOI: 10.1038/s41591-025-03614-w.

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