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Thread: Questioning New Treatments for SCI

  1. #1

    Questioning New Treatments for SCI

    In a conversation with a doctor recently, a comment was made regarding cell transplantation for SCI (Stem Cells for example). The doctor was skeptical as far as the hope for a cure with these procedures, he felt that even if the neuron regrowth were achieved, it would not be realistic to expect them to reattach themselves to the exact destination required to transmit signals properly. He suggests that perhaps a high powered microscope could somehow be used to take a very specific picture of the damaged area, and a surgeon may someday try to repair a fraction of the neurons and get back some function that way. I would love to hear your feedback on this potential scenerio, and also a reply to the skepticism on cell transplantation

  2. #2
    Renee,

    It would be great if your doctor were to come to this site and see what is going on in the field. There are a dozen clinical trials going on around the world, probably several dozen therapies that have been reported to improve functional recovery in animal models, and new leads being developed almost weekly.

    His comment reminded me of a very good friend and neurosurgeon who once said to me that the injured spinal cord is like a strawberry that has been stepped on and he challenged me (and other scientists) to say that there was some way that we can take make the strawberry whole again.

    What many surgeons do not understand (but should know) is the following.

    1. Less than 10% of the connections of the spinal cord is sufficient to support substantial functional recovery. Most people with spinal cord injury already have some of these connections. In fact, this is probably the main reason why over half of people with so-called "incomplete" spinal cord injuries, i.e. have some motor or sensory function below the injury level during the first 24 hours after injury, will recover ability to walk.

    2. The spinal cord is incredibly plastic, sufficiently so that functional recovery can recover even when regenerated connections are not to the same place. Functions such as sex, micturation, defecation, and walking do not require detailed connections because these activities are largely coordinated by spinal cord centers below the injury site.

    3. The spinal cord can regenerate and neuronal replacement is possible with stem cells. The role and goal of surgery in this century will be repair and not excision. This will be done by cell transplants and guiding the repair/regenerative process.

    Finally, the comments of this surgeon remind me of a comment by a British researcher (Geoffrey Raisman, I think) who once said at a meeting something to the effect that "You Americans are so arrogant, you think that the answer to spinal cord injury is to rebuild the spinal cord. The answer will likely be helping Nature repair the spinal cord." I agree with him.

    Wise.

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