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Thread: We present a case of a patient with chronic paraplegia with a complete spinal cord gap resulting f

  1. #1

    We present a case of a patient with chronic paraplegia with a complete spinal cord gap resulting f

    http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract


    Spinal cord repair with acidic fibroblast growth factor as a treatment for a patient with chronic paraplegia.

    Cheng H, Liao KK, Liao SF, Chuang TY, Shih YH.

    Department of Neurosurgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan.

    STUDY DESIGN: We present a case of a patient with chronic paraplegia with a complete spinal cord gap resulting from a stabbing injury 4 years ago recovering after an innovative surgical strategy. OBJECTIVES: To demonstrate the clinical outcome of surgical repair with sural nerve graft with fibrin glue containing acidic fibroblast growth factor in a patient with chronic spinal cord injury. SUMMARY OF BACKGROUND DATA: Spinal cord injury usually causes permanent disability, and there had been not effective surgical technique to obtain satisfactory functional motor recovery, particularly in chronic patients. Previous studies have revealed that acidic fibroblast growth factor could promote axonal regeneration and reduce neuronal death in adult rats with spinal cord injury. METHODS: The spinal cord gap at T11 level was bridged with 4 sural nerve grafts that redirected specific pathways from white to gray matter. The grafted area was stabilized with fibrin glue containing acidic fibroblast growth factor. RESULTS: Before the operation, the paraplegia was identified as ASIA-C, with a motor score for the right and left legs of 12 and 0, respectively, a pinprick score of 77, and 77 on a light touch of left side limbs. His functional status improved from being wheelchair-bound to being able to ambulate independently with a walker 2-and-a-half years after surgery. At this stage, paraplegia was ASIA-D, with motor scores for the right and left legs of 15 and 12, respectively, 86 for a pinprick, and 86 for a light touch of left side limbs. CONCLUSIONS: This case demonstrated significant motor recovery attained in a patient with chronic paraplegia following a repair surgery with nerve graft and growth factor.

    Publication Types:
    Case Reports

    PMID: 15247588 [PubMed

  2. #2
    Well this sounds promising.

    Thanks, Manouli.

    Deb

  3. #3
    you welcome debbie. I wonder if they can do it again with other spinal cord injury people.

  4. #4
    Senior Member Schmeky's Avatar
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    Answer this:

    How can you be ASIA C with a "complete" spinal cord gap???

  5. #5
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    encouraging, but it is looking like once you have paraplegia, you'll always have paraplegia, at best in a reduced form.

    sherman brayton

  6. #6
    Senior Member mk99's Avatar
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    I had Dr. Cheng's surgery in November 2001. I only had the growth factors and not the peripheral nerve bridge because Dr. Cheng didn't think my cord damage justified the peripheral nerve bridge. (ie: not a severed cord or at least not the type of damage that seems to respond best to the nerve bridge)

    Unfortunately my recovery was very limited. I wonder if things would be different with the peripheral nerve bridge?

  7. #7
    Senior Member Schmeky's Avatar
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    If MK99 had it done in 2001, then according to this abstract, this patients procedure would have to have been performed in mid-to-late 2001.

    Mk got little, how can this procedure on someone else (with a seemingly worse injury) result in ambulation?

    If it smells funny. . . . .

  8. #8
    Senior Member mk99's Avatar
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    Schmeky, I had only the nerve growth factors and not the peripheral nerve bridge. Seems that the people who got substantially more function had a severed cord that was bridged by the nerve grafts.

    I think we're comparing apples to oranges here.

  9. #9
    What is spinal cord pathology?
    What is spinal cord anatomy?
    Describe structure of the CORD with picture if possible.

  10. #10
    Quote Originally Posted by Schmeky
    Answer this:

    How can you be ASIA C with a "complete" spinal cord gap???
    The patient was not a "complete" transection. He obviously had a cut of his spinal cord that did not transect the cord. The next time I talk to Henreich, I will ask him. I am pretty sure that he did not mean that the patient was a complete transection and was ASIA C. Wise.

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