6 innovations in the treatment of spinal cord injury

There are very few disabilities worse than paralysis from spinal cord injury. This often results from sudden catastrophes and frequently affects the young and active. It is very poignant that many incidents occur during recreational activities, and horse rising is one prominent example. Nothing exemplifies this more dramatically than the case of Christopher Reeve, famous for playing Superman.

"C Reeve in Marriage of Figaro Opening night 1985" by Jbfrankel - Own work. Licensed under CC BY-SA 3.0 via Commons.
C Reeve in Marriage of Figaro Opening night 1985” by JbfrankelOwn work. Licensed under CC BY-SA 3.0 via Commons.

The damage is typically catastrophic and this MRI scan shows how a fracture of the vertebrae could seriously damage the spinal cord, in this case it affects the neck. Spinal cord injuries often mean a life on a wheelchair or even worse, a bed-bound existence. Rehabilitation is often limited to maximizing potential.

"Cervical Spine MRI (T2W)" by Андрей Королев 86 - Own work. Licensed under CC BY-SA 3.0 via Commons.
Cervical Spine MRI (T2W)” by Андрей Королев 86Own work. Licensed under CC BY-SA 3.0 via Commons.

There are however several scientific advances that will hopefully change the outlook for spinal cord injuries. Here are 6 rays of light at the end of the tunnel.

1. EPIDURAL SPINAL CORD STIMULATION

By Hyung5kim, CC BY-SA 2.5, Link
By Hyung5kim, CC BY-SA 2.5, Link

This is the relatively more established of the 6 procedures. It consists of direct spinal cord stimulation. Research that has shown the benefit is supported by the Dana and Christopher Reeve Foundation-a clear example of celebrity supporting neurology.

2. NON-INVASIVE SPINAL CORD STIMULATION

Proteomics and Spinal Fluid. EMSL on Flikr. https://www.flickr.com/photos/emsl/4799920283
Proteomics and Spinal Fluid. EMSL on Flikr. https://www.flickr.com/photos/emsl/4799920283

By delivering electrical impulses to the spinal cord, researchers have successfully got spinal cord injured subjects to make walking movements. The advantage of this procedure is that it is not invasive. It’s not yet walking, but its a step in the right direction.

3. ROBOTIC EXOSKELETON

Exoskeleton Test Pilot and Ambassador Paul Thacker (AKA Thax) at TEDMED 2011. Ekso Bionics on Flikr. https://www.flickr.com/photos/eksobionics/6644753369/in/photostream/
Exoskeleton Test Pilot and Ambassador Paul Thacker (AKA Thax) at TEDMED 2011. Ekso Bionics on Flikr. https://www.flickr.com/photos/eksobionics/6644753369/in/photostream/

A bit more SciFi is the use of a robotic exoskeleton. Its only one case but anything that may work is worth it.

4. SPINAL CORD REGROWTH

Danio rerio. Thiery Marysael on Flikr. https://www.flickr.com/photos/thierrymarysael/5546556947
Danio rerio. Thiery Marysael on Flikr. https://www.flickr.com/photos/thierrymarysael/5546556947

The future is however more futuristic if trial of regrowing the spinal cord. Its mainly in zebrafish and rats for now, but there is at least a report of using nasal cells to repair the spinal cord in man.

5. NEUROSPINAL SCAFFOLDING

By This image was taken by Ævar Arnfjörð Bjarmason on 2004-04-11 in the Lillebælt, Denmark using a Kodak EasyShare DX4330 camera., CC BY-SA 3.0, Link
By This image was taken by Ævar Arnfjörð Bjarmason on 200404-11 in the Lillebælt, Denmark using a Kodak EasyShare DX4330 camera., CC BY-SA 3.0, Link

And finally, neurospinal scaffolding-this promises to do what it says on the package! It acts as a bridge across the spinal cord injury to aid healing.

6. HEAD TRANSPLANTATION

By Anonymous (Egypt) - Walters Art Museum: Home page  Info about artwork, Public Domain, Link
By Anonymous (Egypt)Walters Art Museum: Home page  Info about artwork, Public Domain, Link

Another potential method is head transplantation, which is essentially spinal cord reattachment. See my previous post on this titled Head transplant, anyone?

https://pixabay.com/en/snake-skeleton-spine-museum-london-955331/
https://pixabay.com/en/snake-skeleton-spine-museum-london-955331/

If you are keen on  more academic take on this topic, an article in Nature titled Spinal cord repair strategies: why do they work? is just the thing for you, and it shows it’s not all doom and gloom.

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Head transplant, anyone?

Coming near you soon, a maverick performing human head transplantation. The idea of head transplantation has a long history. Performing it in humans however is a different kettle of fish.The present day advocate is an Italian neurosergeon Sergio Canavero. He has passionately championed the idea and you should listen to him here at a TED talk.

https://www.youtube.com/embed/FmGm_VVklvo” target=”_blank”>

His attempts have however not convinced the American Neurosurgeons who rebuffed his attempts to involve them. Who would be the guinea pig for Dr Canavero! There is already a patient waiting eagerly, and these journalists discuss the layman’s view of the patient’s perspective.

https://www.youtube.com/embed/pJOQx6XNh-Y” target=”_blank”>

 

A pacesetter or a crank? Too early to pass judgment but history shows that the scientific establishment repeatedly resists ground-breaking progress: remember in-vitro fertilization, antibiotics for peptic ulcer etc? I recently reviewed two books on my other blog, thedoctorsbookshelf.com, and both books, The Rise and Fall of Modern Medicine and Bad Medicine, cite several examples of this type of institutional conservatism. Reassuringly not everyone is dismissing him and some are already talking the ethics of head transplantation.

Canevaro on the other hand seems to have done his homework well. Gauging by this paper which reviews the planned protocol he is taking the matter seriously. And this newspaper article suggests a team will be set to go in 2017!

We have to watch this space.

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