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Thread: Paraplegic woman walks again after experimental operation

  1. #1

    Paraplegic woman walks again after experimental operation

    http://www.ananova.com/news/story/sm...atestheadlines

    Paraplegic woman walks again after experimental operation

    An experimental nerve-graft surgery has allowed a paraplegic woman to walk again.

    The woman whose spinal cord was severed in a car crash, underwent a 14 hour operation.

    Dr Giorgio Brunelli, of Brescia university, removed a portion of the 28-year-old's sciatic nerve in July 2000.

    He used it as a graft to connect the undamaged portion of her spine to muscles in her buttocks and thighs.

    Dr Brunelli said the graft allowed the regrowth of nerves connected to the central nervous system into the muscle tissue.

    The unidentified patient first showed movement in her legs in September and since has begun walking with assistance, Brunelli said.

    The woman had used a wheelchair for five years prior to the surgery.

    American doctor Wise Young is sceptical about the procedure. He believes the permanent severing of the sciatic nerve guarantees a patient loses use of the leg muscle - something that may cause problems if better treatments are eventually found.

    Other spinal cord injury research being pursued includes the use of implantable devices that provide electrical stimulation to promote nerve regrowth.

    Brunelli stressed that the surgery is experimental, but said he plans to operate on a second patient, a man injured in a car crash, next month.



    Story filed: 12:09 Friday 30th August 2002

  2. #2

    Surgery Allowed Woman to Walk

    Yahoo link

    Dr.: Surgery Allowed Woman to Walk
    Fri Aug 30, 3:04 AM ET

    By ANDREW BRIDGES, AP Science Writer

    LOS ANGELES (AP) - An experimental nerve-graft surgery allowed a paraplegic woman whose spinal cord was severed in an automobile accident to reacquire limited use of her legs, an Italian doctor reported this week at a conference in California.


    In a 14-hour surgery performed in July 2000, Dr. Giorgio Brunelli, of the Universita' di Brescia, Italy, removed a portion of the 28-year-old's sciatic nerve and used it as a graft to connect the undamaged portion of her spine to muscles in her buttocks and thighs. He said the graft allowed the regrowth of nerves connected to the central nervous system into the muscle tissue.

    The unidentified patient first showed movement in her legs in September and since has begun walking with assistance, Brunelli said. The woman had used a wheelchair for five years prior to the surgery.

    "It is rudimentary walking - she needs a walker - but she can move," Brunelli said in an interview Thursday.

    Some doctors are skeptical about the procedure, said Dr. Wise Young of Rutgers University, who has followed Brunelli's research.

    Young said the permanent severing of the sciatic nerve guarantees a patient loses use of the leg muscle - something that may cause problems if better treatments are eventually found.

    "If the procedure fails, this is a very major loss. This concept (that) patients have nothing to lose is terribly wrong," Young said. "One shouldn't assume we will have no therapies for spinal cord injury forever - and this is a 28-year-old woman."

    Other spinal cord injury research being pursued includes the use of implantable devices that provide electrical stimulation to promote nerve regrowth.

    Another spinal cord expert criticized the surgery, never before performed in humans, as ethically questionable.

    "Unless you do a very controlled clinical trial, many times you get fooled," said M. Dalton Dietrich of The Miami Project to Cure Paralysis. "We shouldn't be jumping the gun ... there is a major ethical question about doing these types of procedures in people until there is compelling evidence this is the answer to the problem."

    Brunelli wrangled with a medical ethics board in Italy for several years before he received approval to perform the operation. Brunelli said he has experimented on more than 1,000 rats and 40 primates since 1980.

    Brunelli stressed that the surgery is experimental, but said he plans to operate on a second patient, a man injured in a November automobile accident, next month.

    "I will not give any illusions to patients," he said.

    Brunelli presented his results, including a video that shows the woman walking, on Wednesday at the San Diego meeting of the International Society of Orthopedic Surgery and Traumatology.

  3. #3
    I gave this interview yesterday afternoon. It is best if I slightly correct what was represented as my comments. I said that if the procedure does not work, the loss of the leg muscles resulting from cutting the sciatic nerve would be difficult to reverse. Wise.

  4. #4

    Dr. Young

    Would it be possible to graft a portion of the sciatic nerve from a compatible donor if this procedure shows promise?

    Thank you.

  5. #5
    Linda, I have discussed this procedure extensively in other postings including an article on the main carecure site: http://carecure.rutgers.edu/spinewir...Rerouting.html.

    Wise.

  6. #6
    Senior Member Max's Avatar
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    Wow! She was chronic-5 years

    Controversial surgery gives paraplegic limited ability to walk
    ANDREW BRIDGES, AP Science Writer
    Thursday, August 29, 2002
    ©2002 Associated Press

    URL: http://www.sfgate.com/cgi-bin/articl...023EDT0216.DTL


    (08-29) 17:23 PDT LOS ANGELES (AP) --

    An experimental nerve-graft surgery allowed a paraplegic woman whose spinal cord was severed in an automobile accident to reacquire limited use of her legs, an Italian doctor reported this week at a conference in California.

    In a 14-hour surgery performed in July 2000, Dr. Giorgio Brunelli, of the Universita' di Brescia, Italy, removed a portion of the 28-year-old's sciatic nerve and used it as a graft to connect the undamaged portion of her spine to muscles in her buttocks and thighs. The graft allowed the regrowth of nerves connected to the central nervous system into the muscle tissue.

    The unidentified patient first showed movement in her legs in September and since has begun walking with assistance, Brunelli said. The woman had used a wheelchair for five years prior to the surgery.

    "It is rudimentary walking -- she needs a walker -- but she can move," Brunelli said in an interview Thursday.

    The surgery has been met with skepticism by some in the medical community, said Dr. Wise Young of Rutgers University, who has followed Brunelli's research.

    Once the sciatic nerve, the body's largest nerve, is permanently severed, that guarantees a patient loses uses of the leg muscles, Young said.

    "If the procedure fails, this is a very major loss. This concept (that) patients have nothing to lose is terribly wrong," Young said. "One shouldn't assume we will have no therapies for spinal cord injury forever -- and this is a 28-year-old woman."

    Other spinal cord injury research being pursued includes the use of implantable devices that provide electrical stimulation to promote nerve regrowth.

    Another spinal cord expert criticized the surgery, never before performed in humans, as ethically questionable.

    "Unless you do a very controlled clinical trial, many times you get fooled," said M. Dalton Dietrich of The Miami Project to Cure Paralysis. "We shouldn't be jumping the gun ... there is a major ethical question about doing these types of procedures in people until there is compelling evidence this is the answer to the problem."

    It took Brunelli several years of wrangling with a medical ethics board in Italy before he received approval to perform the operation. Since 1980, Brunelli said he has experimented on more than 1,000 rats and 40 primates.

    Brunelli stressed that the surgery is experimental, but plans to operate on a second patient, a man injured in a November automobile accident, next month.

    "I will not give any illusions to patients," he said.

    Brunelli presented his results, including a video that shows the woman walking, on Wednesday at the San Diego meeting of the International Society of Orthopedic Surgery and Traumatology.



    --------------------------------------------------------------------------------
    On the Net: www.sicot.org/
    ©2002 Associated Press

    ==============================
    " They say "Seeing is believing" but the true question is: What do you believe you've seen? Throughout history, the search for faith has lead man to look to the stars and the heavens for answers, but only by looking into ourselves may we truly find it." Outer Limits(Josh)



  7. #7
    Senior Member Max's Avatar
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    Controversy over spine surgery claim

    Controversy over spine surgery claim


    The woman was previously confined to a wheelchair

    Experimental spine surgery has enabled a paraplegic woman to walk again, a doctor has claimed.
    However, spinal experts are concerned about the ethics of the procedure, which they view as untested and highly controversial.

    Dr Giorgio Brunelli, of the Universita di Brescia, Italy, revealed details of the nerve-graft surgery at a conference in California.



    It is rudimentary walking, but she can move

    Dr Giorgio Brunelli
    The woman's spinal cord was severed in a road accident.

    But Dr Brunelli said that following surgery she has regained limited use of her legs.

    In a 14-hour surgery performed in July 2000, Dr Brunelli removed a portion of the 28-year-old's sciatic nerve and used it as a graft to connect the undamaged portion of her spine to muscles in her buttocks and thighs.

    He said the graft allowed the regrowth of nerves connected to the central nervous system into the muscle tissue.

    The unidentified patient first showed movement in her legs in September.

    Dr Brunelli said she had since begun walking with assistance.

    Prior to surgery she had been wheelchair-bound for five years.

    Dr Brunelli said: "It is rudimentary walking - she needs a walker - but she can move."

    Scepticism

    However, some doctors are sceptical about the procedure.

    Dr Wise Young, of Rutgers University, has followed the research.



    We shouldn't be jumping the gun

    Dr Dalto Dietrich
    He said the permanent severing of the sciatic nerve guarantees a patient loses use of the leg muscle - something that may cause problems if better treatments are eventually found.

    Dr Young said: "If the procedure fails, this is a very major loss.

    "This concept (that) patients have nothing to lose is terribly wrong.

    "One shouldn't assume we will have no therapies for spinal cord injury forever - and this is a 28-year-old woman."

    Another spinal cord expert criticised the surgery, never before performed in humans, as ethically questionable.

    Caution

    Dr Dalto Dietrich, of the Miami Project to Cure Paralysis, said: "Unless you do a very controlled clinical trial, many times you get fooled.

    "We shouldn't be jumping the gun. There is a major ethical question about doing these types of procedures in people until there is compelling evidence this is the answer to the problem."

    Dr Brunelli wrangled with a medical ethics board in Italy for several years before he received approval to perform the operation.

    He said he has experimented on more than 1,000 rats and 40 primates since 1980.

    And although he stressed that the surgery is experimental, he plans to operate on a second patient next month.

    "I will not give any illusions to patients," he said.

    Paul Smith, executive director of the UK Spinal Injuries Association, said the woman's case left a lot of questions unanswered.

    He said some people with spinal injuries recovered mobility naturally. The prospects depended to a large extent on whether the spinal cord was completely, or only partially severed.

    Mr Smith told BBC News Online: "If this worked, and the woman has a better quality of life, then that is brilliant.

    "But it does not mean that it is going to work for everybody, and it would be wrong to raise people's expectations. Lots of people have tried things and sort of regretted it later."

    Dr Brunelli presented a video of the woman walking at a meeting of the International Society of Orthopaedic Surgery and Traumatology in San Diego.

    See also:


    20 May 01 | Health
    Spine implant offers hope

    18 Apr 01 | Health
    Nerves 'stretched' for spinal patients

    25 Jan 01 | Health
    Discovery prompts spinal cord hope

    Internet links:


    International Society of Orthopedic Surgery
    Spinal Injuries Association

    The BBC is not responsible for the content of external internet sites

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    ==============================
    " They say "Seeing is believing" but the true question is: What do you believe you've seen? Throughout history, the search for faith has lead man to look to the stars and the heavens for answers, but only by looking into ourselves may we truly find it." Outer Limits(Josh)



  8. #8
    They keep misquoting you Dr. Young.

  9. #9
    Super Moderator Sue Pendleton's Avatar
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    I wish they would give more background information on the patient. While I would normally agree with any and all that severing a sciatic nerve at this point in the game is not what I would call the best move; I would look at it differently if I lived in Italy, especially southern Italy. In most parts of older areas of Mediterrean countries the ability just to leave your own home much less move around town is impossible from a wheelchair. After 5 years of being literally locked in my house I would probably sign up for the same surgery if it were available, free and had even a 1% chance of working. Twenty eight is not young in that area of the world unfortunantly. Not for a single woman anyway. If she lives in Brescia or anywhere north of the River Po I'd have probably waited for a better or more tried therapy to come along. It all depends on what your current circumstances are I think.

  10. #10
    Senior Member mk99's Avatar
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    "There is a major ethical question about doing these types of procedures in people until there is compelling evidence this is the answer to the problem."

    Typical Miami Project Answer. They really JUST DON'T GET IT. You can't win if you don't try... someone makes you look like an idiot and so you slam them for not following your "Basic Research Forever" mentality. What a joke.

    If there is any ethical questions here it's about how does one sleep at night while sitting on knowledge & info that can prevent so much human misery, suffering & death.

    Just imagine what could be accomplished if Miami Project was shut down and the money was given to someone who actually WANTS to solve the problem and not just study SCI forever at our expense.

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