Abstract
Cervical spinal cord injury (SCI) impairs sensorimotor and autonomic functions. We investigated the effects of lumbosacral transcutaneous spinal cord stimulation (tSCS) on urinary bladder, bowel, and sexual function as well as cardiovascular and sensorimotor functions in one individual with chronic clinically motor-complete cervical SCI, 11 years post-injury. Following 30 sessions of lumbosacral tSCS, the individual presented with improved urinary bladder compliance as well as anorectal function in parallel with mitigation of the severity of autonomic dysreflexia during filling cystometry and anorectal manometry. In addition, long-term tSCS improved erectile function and sexual satisfaction. Furthermore, after long-term tSCS, concurrent tSCS enabled voluntary leg movement. This case study demonstrated the multi-system benefits of lumbosacral tSCS, which holds promise for evolving into a clinically viable therapy for restoring both autonomic and motor functions following SCI. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s42234-025-00183-8.