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.