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Thread: What benefits for longterm SCI?

  1. #1

    What benefits for longterm SCI?

    Many of us are many years post injury. We have many permanent changes like contracures and decreased bladder capacity. What can we realistically expect to happen? Would sensation or mobility improve first? What modality might be most effective? I remember the news alerts when they began using the massive steroid dosages for new injuries. Is it possible for something similar to occur for longterm injuries?

  2. #2
    Free,

    Reconnection of spinal cord pathways is only part of the cure. Problems such as atrophy, contractures, and bony loss must be reversed through exercise and use. People who have flexible muscles and joints, and good bone, would be able to get going on the exercise programs earlier and more intensively. Otherwise, one must build up the activity slowly.

    Whether the chronically injured spinal cord will respond to certain therapies is still uncertain at the present. As pointed out earlier, the process of regenerating the spinal cord must address several known problems:
    • inhospitable growth environment at the injury site.
    • growth inhibitors in the remaining spinal cord above & below the injury
    • appropriate reconnection of axons to the appropriate sites.

    Many of the therapies being considered and tested in animal studies are addressing the first and second problem. The last problem may be overcomed by activity induced plasticity of the brain and spinal cord. I suspect that all regenerative therapies must be accompanied by intensive exercise programs to maximize recovery. However, this is only theory and must be tested empirically.

    Finally, I am optimistic that chronically injured spinal cords will respond to the therapies for several reasons. First, the work of Hank Bohlman and others suggesting that decompression and untethering of compressed spinal cords even years after an injury may lead to substantial recovery suggest that the axons are still alive and ready to respond. Second, activity-induced recovery of function have been reported in some people as long as a decade after injury. Third, while most of the studies have been in younger people, there does not yet appear to be any age-limit to recovery. These are of course speculation and must be confirmed but I don't see any evidence so far that one should give up hope if one has chronic spinal cord injury.

    Wise.

  3. #3
    Senior Member Red_1 Canada's Avatar
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    Hank Bohlman

    Dr.Young;

    Do you have any papers written by Mr. Bohlman?
    I couldn't find anything on the web. I am very interested in decompression.
    As I have a burst fracture and am still being pinched.

    Where does Mr.Bohlman do his work?

    Anything?

    Thank You!

  4. #4

    Thank you, Wise

    I'm not personally discouraged at all, even though I don't have great expectations after 30 yrs of SCI. My question is more academic since it seems that some people think a cure will allow them to return to "normal" function. Any improvement will be helpful, but the potential for chronic SCI seems limited. Bodies that have been stuck in w/c's for many years, like mine, have settled into a semi-fetal position. Attempting to straighten them will take much time and cause significant physical pain, IMO. My hope is that some improvement in sensory levels (I guess there'll be some pain here, too. It was very painful when I began to get return many years ago.) will occur. Potentially this will help with B&B function, skin integrity, and sexual function and pleasure. When I compare people with post-polio to people with SCI, they seem to be generally more productive and healthy. They also seem to have better B&B, sex function, and little or no problem with skin breakdowns. This level of function seems more likely than actual ambulation or other physical activity. Of course, newbies should fare much better. Again, IMO.

  5. #5
    Red, I wrote a summary of Bohlman's work in July 2002 http://carecure.rutgers.edu/spinewir...ompression.htm

    Free, I agree. The cure will not give people a new body. It hopefully will restore motor, sensory, and autonomic functions.

    Wise.

  6. #6
    Well I'm hoping the cure WILL return normal function though I realise the effects of sitting for 20 years plus will be difficult to overcome. I'd like normal function for someone of whatever age I am when I'm cured, not a 24 year old as at the time of my accident.

  7. #7
    Senior Member alan's Avatar
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    If you've got a scoliosis, you'll still have it after your cord is regenerated, I'd assume. Since able-bodied people can't reduce a scoliosis via exercise, it's hard to imagine we could.

  8. #8
    Just trying to stay positive for my own sake more than anything but am I right in saying you can walk with scoliosis - my mother has incredible sideways curve of her spine - we looked at an x-ray the other day, she's had it for decades

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