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In this study, we evaluated the role of residual supraspinal and afferent signaling and their convergence on the sublesional spinal network in subject diagnosed with complete paralysis (AIS-A).Methods: A combination of electrophysiologic techniques with positional changes and subject-driven reinforcement maneuvers was implemented in this study. Electrical stimulation was applied transcutaneously at the T9-L2 vertebra levels and the spinal cord motor evoked potentials (SEMP) were recorded from leg muscles. To test the influence of positional changes, the subject was placed in (i) supine, (ii) upright with partial body weight bearing and (iii) vertically suspended without body weight bearing positions.Results: Increase in amplitude of SEMP was observed during transition from supine to upright position, supporting the role of sensory input in lumbosacral network excitability. Additionally, amplitudes of SEMP were facilitated during reinforcement maneuvers, indicating a supralesional influence on sub-lesional network. After initial assessment, subject underwent rehabilitation therapy with following electrophysiological testing that reviled facilitation of SEMP. Conclusion:These results demonstrate that combination of electrophysiological techniques with positional and reinforcement maneuvers can add to the diagnostics of discomplete SCI. These findings also support an idea that integration of supraspinal and afferent information on sub-lesional circuitry plays a critical role in facilitation of spinal sensorimotor network in discomplete SCI.

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The article is devoted to the construction of lattice endoprosthesis for a long bone. Clinically, the main idea is to design a construction with the ability to improve bone growth. The article presents the algorithm for such a design. The construction should be produced by additive manufacturing. Such an approach allows using not only metallic materials but also ceramics and polymers. The algorithm is based on the influence function as a method to describe the elementary cell geometry. The elementary cell can be described by a number of parameters. The influence function maps the parameters to local stress in construction. Changing the parameters influences the stress distribution in the endoprosthesis. In the paper, a bipyramid was used as an elementary cell. Numerical studies were performed using the finite element method. As a result, manufacturing construction is described. Some problems for different orientations of growth are given. The clinical test was done and histological results were presented.