Scientific advancements in spinal cord injury and paralysis recovery

Scientific advancements in spinal cord injury and paralysis recovery

Posted by AskNurseLinda on Sep 24, 2018 10:25 am

e6e050970713ff3a49cf33b77da1d2a8-huge-drOne of the best things about spinal cord injury research is that it can be used to help aide the recovery for individuals with nerve paralysis from any disease or accident. It can even go so far as to assist in the recovery of individuals with any neurological issue.

Research has focused on trauma for a very important reason. In trauma, the time, source and level of injury is clearly identified. This becomes part of a natural experiment. Scientists can pinpoint exactly how, where and when the trauma occurred. That does not mean that the research does not apply to those with disease. It does. The control of when the disease exactly started may not be known. In some diseases, the presence of the disease might not be known until symptoms appear although, it could have been there since birth or even before. Disease might affect many levels of the brain and spinal cord.

Any research that is performed for the recovery of spinal cord injury applies to both trauma and disease origins. The application and outcomes of the research are the same. Therefore, any research that propels information about recovery of paralysis. In other words, it is helpful to know more of the controls of research, but the application is beneficial to everyone. Even if research is conducted with those who have trauma, it still applies to those who have disease.

Over the last few weeks, some topics about the natural function of the spinal cord and central nervous system have been presented. The Central Pattern Generator is a reflex within the spinal cord that promotes stepping, outside of the brain’s control. This stepping pattern follows an external stimulus of moving the legs in a rhythmic motion. Another concept is neuroplasticity which is a way that the body will attempt to heal itself in that the work of the central nervous system which is sending messages back and forth to the body, will attempt to find alternative routes.

Today, scientists are examining different possibilities to reduce injury, and to improve function. There are experimentations in laboratories and with humans. Some focus on specific issues such as reduction and healing of pressure injuries, bowel and bladder function, cardiac care, as well as studies of equipment that will improve the quality of life. There are studies that are being conducted to reduce the physiological effects of spinal cord injury and paralysis in general.

At the time of traumatic injury or at certain times in progression of chronic diseases, swelling can be an issue. This is because the central nervous system (the brain and spinal cord) are housed in a boney frame of the skull and vertebrae. Bones cannot expand to accommodate natural swelling that the body uses to protect areas that have been injured. The vertebrae or bones in the back have separations that allow for movement, but this is not enough room to accommodate swelling. Therefore, when the body uses its natural protection from injury, delicate nervous system tissue is further damaged from the compression of the swelling. This is called secondary injury as the spinal cord injury is not really the problem, it is the natural swelling that occurs immediately after injury.

There have been and still occurring studies of medications that can be delivered to reduce the swelling and thereby reduce the damage from swelling. A study of a steroid, methylprednisolone was conducted about twenty years ago. This was an extensive study which demonstrated that only a very specific type of trauma would benefit from its use. More studies are being conducted with this medication as well as other medications that also reduce swelling. Stay posted as the more information about the nervous system’s functioning is understood, the use of these medications will be better understood. However, many medical professionals use the medication, especially during surgery and with disease to avert swelling issues.

One factor that does seem to reduce the secondary complications of spinal cord injury is early stabilization surgery of the spine. Years ago, it was thought to wait until swelling subsided before surgical stabilization occurred, in about 3-4 days or longer. In some cases, casts, halo braces or body casts were applied to stabilize the area. Today, immediate surgical stabilization is performed as soon as a person is stable enough to undergo the surgery. This counteracts other secondary complications that can occur while waiting for the area to heal on its own. It reduces the chance of further injury to the area from movement especially while turning. It also allows the individual to start to sit upright, reducing the risk of pneumonia. After stabilization, movement can be introduced to provide feedback to the area of the body below the spinal cord injury.

Long term, many studies have been conducted to improve quality of life as well as to reduce paralysis. Nerve transfer surgery is rapidly improving function in parts of the body. This is especially true with the arms and bladder. All nerves outside of the brain and spinal cord are peripheral nerves. Peripheral nerves can be rerouted, split and grafted. Nerves have been moved to improve pinch, grip, hand and arm function. There have been lower extremity nerve surgeries, but these are less often done because of the weight and balance issues of standing.

Peripheral nerves in the cauda equina or the nerves that come out of the tail of the spinal cord have been used and without implants to provide better toileting. Only a few specialists can perform these types of surgery. There have been implantable systems used in the past, but these have faded as the costs have outweighed outcomes however, specific devices still are available. Others have been too cumbersome for effective use. This type of reconstructive therapy will return when the devices are more cost effective and less burdensome for the user.

The history of stimulation of nerves below the level of injury has really come to the forefront. At first, applications of electrical current have been used externally on the skin through biking and stepping equipment. Any patterned movement will start the process. With further research, the idea of electrical stimulation implants has come to the forefront and is currently being tested. This research is being conducted around the world.

A spinal cord injury research revolution is underway. A group sponsored by the Christopher & Dana Reeve Foundation, is having success with implants that bridge the actual spinal cord injury. This provides a way for messages to be sent around the spinal cord injury. The results are pending until the study is complete. The preliminary study demonstrated great promise with gross movements, improvement in bowel and bladder function. A recent sub-study in a very small group demonstrated improved cardiac and respiratory function. These studies are being very carefully performed and are rapidly producing positive outcomes. Keep watching the Foundation website for updates about this exciting work.

Another area of research that is being conducted is stem cell research. The focus of this research is to implant nerve cells into the central nervous system. Stem cells are cells that have not yet been determined as to what type of tissue they will become. The main issue with this research is getting the stem cells to grow in or around the spinal cord injury. They can be implanted and survive but they don’t seem to be able to grow through the ‘scar’ surrounding the spinal cord injury. This is another area that will boom once more information about dissolving the ‘scar’ and further information about the nervous system is discovered. It must be noted that stem cells are not fetal material but can be made from the individual’s own tissue from the skin or high up in the nose. This reduces any rejection factor.

There are many individuals who would be delighted to sell you a cure for spinal cord injury or paralysis. I see these ads and people tell me about ‘opportunities’ for some of these treatments. So far, these have all turned out to be scams. It is heartbreaking when you want something so very much and there is always some person who is willing to prey on your frustrations.

If there was really a stem cell treatment or any curative treatment that worked, everyone would be after it. Medical professionals would provide you with information about it. Always be sure to check with your healthcare professional to be sure you are involved with a real and ethical treatment center. Also, you want to know about the details of the treatment to ensure you will not be cutting yourself out of real research possibilities in the future or that you will not be harming your body.

As you can see, research strategies change through the years. Science seems to be going in one direction and then something else pops up. To be sure, there is more positive research about spinal cord injury now than ever before. Waiting even one more day is too long. But ensuring a true and effective treatment is the goal. One of the best things about spinal cord injury research is that it can be used to help aide the recovery for individuals with nerve paralysis from any disease or accident.  It can even go so far as to assist in the recovery of individuals with any neurological issue.

Nurse LindaI'm online in this community every Wednesday from 8-9 PM ET to answer your SCI and paralysis related questions.

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