The future of spinal injury treatments

June 27, 2017

For those suffering with the devastating and life changing impact of a spinal injury, there has never been a time with so much hope for spinal system repair and treatments. Recent medical advancements, compounded by technological developments, innovation and invention meanthat a cure for paralysis may soon be possible.

What is a spinal cord injury (SCI)?

Spinal cord injury (SCI) happens when the spinal cord becomes damaged by vertebrae fractures that crush or transect the spinal cord, often the result of injuries sustained from motoring accidents, falls, assaults or sporting accidents.

Spinal cord injuries interrupt the constant stream of electrical signals from the brain to the body which can lead to impairment, loss of muscle movement, muscle control, sensation and body control - resulting in paralysis below the point of an injury.

Improvements in emergency care and therapy have made SCI manageable but researchers continue to investigate ways to make it repairable.

Here, are six major ground-breaking treatments currently being pioneered by scientistsaround the world.

Revolutionary New Drugs

In recent years, US scientists have been developing a revolutionary new drug that encourages nerves in the spinal cord to grow and repair.

The drug works by interrupting the process of scar tissue formation which prevents nerve cells from growing after an injury. Research found that sugary proteins that form in scar tissue act like glue and prevent the spinal cord from repairing. 

The outcome of the study, published in the journal Nature, showed promising results indicating that a degree of bladder control and movement, in paralysed patients, could be restored.

The drug, while showing great promise, is still in early stages of development and requiresfurther testing in larger animal studies before human trials can take place.

Nerve Transplants

Recently, British and Polish scientists made an historical breakthrough in the treatment of spinal injury when they successfully reconnected the severed long spinal nerve fibres of a man paralysed from the chest down after a knife attack.

The pioneering therapy involved transplanting cells from the man’s nasal cavity into his spinal cord which acted as a bridge over which damaged connections could grow back enabling him to walk again with the support of a frame.

Further details of the research are published in the journal Cell Transplantation.

Electrical Nerve Stimulation Therapyspinal injury

A recent study in the Journal of Neurophysiology reported that peripheral nerve stimulation can reverse SCI-associated nerve deterioration. This may be a new way of preventing long term changes to nerve and muscle function after SCI and improve the benefits of current and emerging rehabilitation treatments.

A research team from the University of Sydney in Australia tested SCI patients (within six months of their injury) with 30 minutes of electrical nerve stimulation therapy five days a week for six weeks on one limb.  After six weeks of therapy the research found that the nerves in the treated limb responded more like nerves in a healthy subject. 

The study showed clear benefits of an intensive six-week peripheral nerve stimulation program and further benefits with continued therapy. The findings prompted researchers to advocate for the incorporation of peripheral nerve stimulation into neuro-rehabilitation programs, as soon after injury as possible.

Stem Cell Regeneration

In 2016, an international team of experts, led by researchers at the University of California,San Diego (UCSD), used stem cells for the first time to repair damaged spinal cords and restore movement.

The team of scientists used neural stem cell grafts to regrow tissue in the spinal cord of a rat, reconnecting severed lines of communication between the body and the brain, resulting in increased movement and function in the front legs.

The findings of the research are significant in that they show the regeneration of nerve cells at the critical junction between the spine and brain is possible and that axions (the tails of these cells) have within them the ability to repair.

The findings of the study are published in the journal Nature Medicine.

Human stem cell regeneration trials are now underway at the University of California San Diego’s Sanford Stem Cell Clinical Center where four patients have been treated with neural stem cells injected into the spinal cord. 

The Exoskeleton: Wearable Robotics

Wearable robotics sound like something out of a science fiction movie but recent advances in bio-mechatronics and medical care have made exoskeleton technology an increasingly common feature in rehabilitation programmes. An exoskeleton is designed to provide power assisted movement to help patients build strength and movement in fully or partially paralysed limbs.

A recent report in Medical Devices: Evidence and Research found 76% of patients using powered exoskeleton systems could move, without physical assistance, on completion of their training programme.

The report concluded that powered exoskeletal systems could allow spinal cord injury patients a safe means of movement, conducive to prolonged use.

The technology, however, is still very much in its infancy and not widely available outside of the clinical environment of research facilities, hospital wards and rehabilitation centres.

Growth Hormone Therapy

Research presented in 2017 at the European Congress of Endocrinology in Lisbon, is the first study to investigate the link between spinal injuries and growth hormone deficiency (GHD). 

The study found that growth hormone treatment combined with physical therapy over six months significantly improved sensory function in patients with complete spinal injuries and could lead to potentially life improving treatments for patients with spinal injuries.

During the study at Hospital Quiron-Teknon and Guttman Institute in Barcelona, 18 patients with SCI were treated with growth hormone or placebo over six months. 

The outcome of the study revealed those treated with growth hormone improved significantly in self-care, respiration and sphincter control and regained greater feeling below the site of the spinal injury than the control group.

Whilst the results are promising, further research will be required to examine the differences between acute, sub-acute and chronic spinal injuries and to investigate treatment at different doses of growth hormone.

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