Abstract

Spinal Cord Injury (SCI) imposes profound physical, socioeconomic and clinical burdens, with limited options for functional restoration. This manuscript explores the transformative potential of neurotechnology in addressing paralysis, spotlighting the NeuralEXO exoskeleton-a neuro-controlled, AI-integrated system designed to restore mobility by translating neural signals into mechanical motion. We examine the innovation landscape, including brain-computer interfaces, neuromodulation and regenerative therapies, supported by initiatives like the NIH BRAIN Initiative and DARPA’s N3 program. A critical focus is placed on anesthetic management during spinal implant surgeries, comparing dexmedetomidine and propofol under target-controlled infusion paradigms. Dexmedetomidine demonstrates superior preservation of motor and somatosensory evoked potentials, reduced hemodynamic instability and enhanced recovery profiles, though propofol remains valuable for its titratability. Challenges such as autonomic dysreflexia, signal latency and device safety are addressed, emphasizing the need for interdisciplinary collaboration and robust clinical protocols. By integrating advanced neurotechnology with optimized intraoperative care, this work underscores a path toward redefining functional recovery in SCI.

Keywords:Spinal cord injuries; Exoskeleton device; Brain-computer interfaces; Neuromodulation