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Thread: discouraging news for low spinal injuries

  1. #11
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    Dr Young,

    I was interested in your reply to sherman about understanding your neurological level, I have a low level injury due to a prolapsed disc, which I was told was at L5-S1. I can flex my foot towards my head and wiggle my big toes upwards and I believe from your reply and other research I have done that my L5 nerve has not been greatly damaged (if at all) by the injury. I have no 'lift' in my walk and by toes make a clawing action, I would interested to know which nerve roots are related to these problems.

    Another curious thing is that although I use self intermittent catheters I find that occasionally (maybe a day each month) I find I can urinate for a few seconds before using my catheter, I ususally know that this is going to happen as I experience some pain in my genital area just prior to the event. I have spent some time investigating a product from Interstim which places a wire close to the nerve roots to the bladder, and with electrical stimulation opens the sphincter. I have discussed this system with my urologist but I would appreciate your opinion on its suitability for an injury such a mine, I know it does not involve cutting any of the nerve roots.

    I have found during the 30 months after my injury that some slight sensation has returned to areas around my anus and a really weird thing is that I can feel the outer ring around by foreskin but nothing else on my penis, is it likely after such a long time that this return of sensation could continue.

    Finally, does peripheral nerve bridging has any relevence on an injury like mine or could you suggest what may be of potential benifit in the years ahead.

  2. #12
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    Dr. Young:

    You said: "However, the spinal cord between T10 and L1 contain the lumbosacral enlargement. The neurons that control some of your leg muscles and bladder/bowel/sex function reside between T10 and L1."

    I have a T-9 burst (complete). I was diagnosed as a T-10 in the San Jose hospital in which I recovered. Another doctor says my neurological level is T-9. Am I in the lumbosacral enlargement loop? The possibility of regaining bowel-bladder-sex function would be great. But is my level too high?

    This is a good forum.

  3. #13
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    no-
    if your injury is T9 you're ok. It's T12 and below that is the difficulty. There is no doubt that any neuronal damage in the Lumbosacral spinal cord is fatal to functioning of the spinal cord. People with complete T12 and below SCI's, who have not recovered naturally will never, ever recover sexuality/walking, etc. Nothing in the next 100 years will fix this. It is not only safe, but 100% accurate to say that recovery in this case is 100% impossible, today, tomorrow, 10 years, etc. Do not believe what anyone may preach about physical therapy and axonal regeneration, neuronal replacement for the Lumbosacral spinal cord will never be done in ANY of our lifetimes. This will remain an enigma dacades and decades, and decades to come. If you are 10 years old now with this problem, maybe, just maybe will you benefit by the time you are 70.

    sherman brayton

  4. #14
    Senior Member mk99's Avatar
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    Brayton I would kindly ask you to lay off the "never ever" doomsday talk. I'm not asking you as a Moderator, just as someone who doesn't want urine in his cereal with every post you write.

    thanks

  5. #15
    I always say never say never. We all get negitive at times, but it is best to never give up hope. For now, just try and live your life the best you can.

    "Life is about how you
    respond to not only the
    challenges you're dealt but
    the challenges you seek...If
    you have no goals, no
    mountains to climb, your
    soul dies".~Liz Fordred

  6. #16
    I have been injured OCT 8th 1992 and heard ever since there will be a cure. But, I was aware that I was a T12/L1 and all I was hearing was bullshit. Everytime I asked about a cure for Lower Paras I never had a response. So, one day I was invited to a open house (the first one) at Rutgers with Wise (since leaving NYU)and he said there that he believes (after someone asked him)there will be a cure for all of us. I sat there thinking "bullshit"! So, I raised my hand and asked about Flaccid Para's, his head dropped and his eyes drifted in thought and responded somewhat this way, new research has opened the path that even the low level paras have a chance at a cure. But here we are again still debating it. I will say this as I said it a thousand times, a cure will not come from this country. THis country is motivated by greed. I said this before Wall Street was exposed. Now if we can't trust wall street, our corporations, what makes you trust our reasech facilities. It is all about money. Sure their is a lot of good that comes from these facilities, but it is bogged down from greed. Greed holds back progress. These colleges that oversee most of these facilities use them for grants and learning tools. The longer they drag it out the better the financial results. Aministrations of College's across our nation are manipulators. Look at what it costs to go to college. Anything that coincides with outflows with the Gov't is partly corupt. An example is medicare. Everytime the gov't increases patient care, doctors and hospitals raise their fees. Didn't i just read an article about CR had a secrete operation, yetI thought he was recovering from all this harness and exercise bullshit (traing the spinal cord like a dog) He was promoting all this electrical crap that isn't even practical for flaccis paras and yet you never see a footnote in the ads. Thats right don't believe the hype - the fact that question is still being raised is still proof to me that no one really knows WTF is going on SCI. Hey I am know expert and don't claim to be, but I haven't met the guy who knows yet either. Oh I'll get that same speech about my negativity from the same ole people but its the same ole story

  7. #17
    Kenney, I am sorry that you feel this way. Several years ago, you had asked me a question that I had no answer for and I told you so. I also told you that I believe that it is a solvable problem but that we are not yet close to a solution.
    I am not sure that I understand what you are saying. Are you saying that there is a solution and that scientists are not telling you the solution because of greed? Are you suggesting that Christopher Reeve has gotten a secret operation and is recovering because of that operation? Wise.

  8. #18
    Kenney makes some good points. He didn't say the cure was found-He said they are dragging it out to collect more grants. I don't think he is far off on that statement. Possibly the SCI research Community took the stand that a cure was at hand to bring in more research money-now the truth is coming out.

  9. #19
    Originally posted by Steve Oakes:

    Dr Young,

    I was interested in your reply to sherman about understanding your neurological level, I have a low level injury due to a prolapsed disc, which I was told was at L5-S1. I can flex my foot towards my head and wiggle my big toes upwards and I believe from your reply and other research I have done that my L5 nerve has not been greatly damaged (if at all) by the injury. I have no 'lift' in my walk and by toes make a clawing action, I would interested to know which nerve roots are related to these problems.

    Another curious thing is that although I use self intermittent catheters I find that occasionally (maybe a day each month) I find I can urinate for a few seconds before using my catheter, I ususally know that this is going to happen as I experience some pain in my genital area just prior to the event. I have spent some time investigating a product from Interstim which places a wire close to the nerve roots to the bladder, and with electrical stimulation opens the sphincter. I have discussed this system with my urologist but I would appreciate your opinion on its suitability for an injury such a mine, I know it does not involve cutting any of the nerve roots.

    I have found during the 30 months after my injury that some slight sensation has returned to areas around my anus and a really weird thing is that I can feel the outer ring around by foreskin but nothing else on my penis, is it likely after such a long time that this return of sensation could continue.

    Finally, does peripheral nerve bridging has any relevence on an injury like mine or could you suggest what may be of potential benifit in the years ahead.
    Steven, what you describe sounds like damage to your spinal roots rather than the spinal cord itself. The spinal cord ends at L1. At L5-S1, there are only spinal roots. You may have damaged some of your spinal roots L5, S1, S2-S3, S4-S5 and below. These roots respectively control the muscles to your knee (L5), your ankle/foot (S1), your bladder (S2-3), and your anal sphincter (S4-5). Usually, a disc damages only some of the roots. It is possible with a careful neurological examination to figure out which roots were damaged, by testing the reflexes, sensation, and voluntary contraction of each of the muscle groups. The spinal roots are a special case of peripheral nerve injury. Because the dorsal root sensory ganglia (which send sensory axons to the spnal cord and to the periphery) are situated just outside of the spinal canal, the sensory fibers that are damaged are the ones that go from the dorsal root ganglia to the spinal cord. While sensory axons in peripheral nerves can regenerate, they cannot re-enter the spinal cord (at least not well). Therefore, sensory improvement after spinal root injury is usually limited. Motor axons, however, should be able to grow from the injury site to re-innervate the muscle. The fact that you can wiggle your toe suggests that your S1 root may still be largely intact or may have regenerated.

    Regarding the use of peripheral nerve bridging to restore function after spinal root injuries, there is now several groups that are working on this problem. I spoke to Dr. Zhang from Shanghai last year in Tampa and he had been connecting peripheral nerves to ventral roots above the injury site. He claims that people are getting some bladder function back. Unfortunately, he has not yet published any of his data in non-Chinese journals. Recent news articles suggest that Dr. Clifton is trying to test this approach in sheep and is thinking of taking some peripheral nerve bridging into clinical trials. This is good because, to my knowledge, this is the first time that an American neurosurgeon is seriously investigating this approach with the intent of taking this to clinical trial. Finally, I am very heartened by the news that Dr. Jim Guest at Miami Project is thinking seriously of doing OEG transplants to try to regenerate spinal roots.

    Wise.

  10. #20
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    Kenney, we have to look at the good and the bad to make balanced judgments about things. I've seen SCIs and others who consider anything negative as sinful because it shakes your faith. Amway, quacks and faith healers make millions of dollars feasting on these gullible souls. There are some SCIs who refuse to listen to constructive criticism and lash back against those who practive it. Healthy skeptism is a good thing. It helps us see things when they're out of order.

    However, you have taken negativity up a few notches to the point that your irrational and extremely angry. Venom crushes sound judgment and civility toward others. Extreme cynicism, hatred or both can turn into paranoid delusions that are self-destructive and destructive to others.

    However, it's OK to vent because it's damn hard to cope with a catastrophic injury that leaves you paralyzed and impotent. But we lose credibility when we make ad hominem attacks, or character assasinations, without facts to back it up.

    I think Dr. Young is sincere, competent and caring. We're darn lucky he's on our side. I can't imagine him being deceitful, evasive or dishonest. He's a treasure chest for the SCI community.

    I also have problems with anger as do many disabled people. In fact, I'm in a psychological rut because I envision worst-case scenarios, especially in relationships. This leads to loneliness, despair and suspicious of others. I haven't made much progress in accepting my T-9 complete injury from an car accident on March 13, 2000. I'm going to sign up for an anger management course.

    Hang in there, man.

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