Page 1 of 2 12 LastLast
Results 1 to 10 of 14

Thread: can damaged incomplete sci be seen with mri

  1. #1
    Senior Member da lurker's Avatar
    Join Date
    Jun 2005
    Location
    29 ° N 81 ° W
    Posts
    571

    can damaged incomplete sci be seen with mri

    can damaged on the spinal cord (incomplete) be seen with mri

  2. #2
    An abnormal MRI may indicate spinal cord damage, but cannot detail the damage to individual neurons and may not correlate directly with dysfunctiion. I will let Dr. Young elaborate on this.

    (KLD)

  3. #3
    Senior Member
    Join Date
    Jun 2005
    Location
    Norway
    Posts
    17,427
    Excellent question Tex.

    I have also wondered about that scenario; I had an AVM removed from my Th4-Th8 area in the spinal cord itself some time ago. It was first detected by means of MRI, secondly by Angiography. During the time I went trough for fixing the AVM I underwent several examinations with MRI and Angiography.

    Today I’m “medically” treated and the AVM is removed after embolization and finally surgery. The follow-up MRI’s shows “No” signal changes and the spinal cord appears as “healthy/normal”…

    If for instance a cure (implementing stem-cells)! How will the doctors be able to detect the problems with the spinal cord I have? How can they pinpoint the damaged areas? It my look fine on images but it is not, I have to use crutches and a wheelchair in my daily life.

    Is there any other means to be used above MRI to detect spinal cord problems? Are there new apparatuses designed or in the progress to find such problems? Are there any biotech methods to detect such problems? I know a lot of engineering is performed all the time for improving MRI machines and hopefully we will have such equipment in due time for a cure.

    I’ll be very grateful for explanations and comments on this subject by Dr. Young.

    Leif

  4. #4
    An electrodiagnostic test used sometimes is the SSEP (somatosensory evoked potential). It is still a rather crude test, as it does not tell you exactly the extent or even the exact location of a lesion, but it can tell you if it is brain, cord, or peripheral nerve.

    PET scans can be used to look at metabolic activity of the brain and spinal cord, but are only available for non-research use in a few hospitals.

    (KLD)

  5. #5
    Senior Member
    Join Date
    Jun 2005
    Location
    Norway
    Posts
    17,427
    Thank you very much KLD.

    You have to excuse me a bit here. I guess you have to be a bit patient with me;

    Up to recently I have been studying all kinds of books and the internet to be able to understand the nature of lesions like AVM’s, the approaches and procedures to remove them etc.
    Finally all this is done, the problem is removed. Now I feel like I have to start from scratch again (puh) and study and understand and be prepared for a cure that will be here sooner or later.

    I believe that I will not need a SSEP, since it will not tell exactly where the problem is. And I know for sure that it is not the brain (some will say it is) or the peripheral nerve system.

    Like I said above, the MRI films show a “healthy” cord. But again, it is not healthy. And also when I had surgery to remove it, a fine doctor, Dr. Robert F. Spetzler told me after the surgery that everything went fine but he could see some errors inside the cord in his microscope, but he was not sure how that would effect me. Ok, here he could see problems but the MRI could not.

    I have looked into this PET scan techniques; there are some machines here in Europe of those as well. They have at least one nearby in Stockholm. I have also checked that they have them in France and the cost for an examination is not to scary.

    Well, I believe I am pushing a bit here now. I know there will be some more years for a “cure” is available for fixing cords, and it all depends on how therapeutic procedures to do this will be like. But my question at this stage will be like; do you think that in my case or similar cases that the PET scan technique will be a good aid for say doctors if they would have done an attempt for injecting or placing stem cells in the cord at this time?

    Thanks again.


  6. #6
    Senior Member
    Join Date
    Jun 2005
    Location
    Norway
    Posts
    17,427
    I know my question can be a bit hypothetical, but if it can’t be answered precisely at the moment, maybe a hypothetical answer can be given. It will be interesting to know.

    I believe that scientists must have some views or ideas on how such an approach could have been done today regardless of the fact that the cure is not here already. It’s a bit difficult to say exactly what I’m after but something like this;

    - In an injured cord; what will be the approach to detect errors for a treatment?

    - Will there be several procedures for doing that, and which could it be?

    - What will be the most likely treatment method (say for stem-cells)? Will it be surgery? Or will it be injections? Which could be better than the other and vice versa?

    - Are there any obstacles today when it comes to techniques and procedures for doing stem-cell placements in the cord? And what could those problems be?

    I guess I’m asking questions that are not related to stem-cell research itself, but questions around the topic and techniques to be able to do the cure when the cells are available. I know the techniques will be related to the cure, but above that some thoughts must have been done?

    Thanks again.

  7. #7
    Leif, I have asked Dr. Young to review this, but he has been very busy with the transition of our new website. I am sure he will get back to you with a better discussion of this topic than I can provide.

    (KLD)

  8. #8
    Quote Originally Posted by Leif
    In an injured cord; what will be the approach to detect errors for a treatment? Will there be several procedures for doing that, and which could it be?
    • Leif, I don't really understand the phrase "errors for a treatment". Do you mean areas of injury and are you asking for where cells will be transplanted? If so, the answer to your question depends on the cells and whether they migrate, cross the blood brain barrier, or cross the cerebrospinal fluid-spinal cord barrier. Some cells migrate while others do not in the central nervous system. Three factors control whether a cell will migrate in the brain or spinal cord. The first is of course whether the cell is the type that migrates. The second is whether the central nervous system recognizes the cell as a peripheral cell and tries to wall it off with astrocytes. The third is whether there are materials in the extracellular space that stops cell migration. For example, olfactory ensheathing glia (OEG) will migrate readily in tissues, is recognized as part of the central nervous system, and therefore tend to migrate extensively after transplantation. However, it may slow down or stop in the presence of chondroitin-6-sulfate proteoglycans (CSPG an extracellular matrix material that also stops axonal growth). So, several laboratories are looking into the possibility of treating the spinal cord with chondroitinase (an enzyme that breaks down CSPG) at the time of the OEG transplants. Usually neural and embryonic stem cells will migrate as well. However, some cells such as umbilical cord blood or bone marrow stem cells, and Schwann cells do not migrate well in the brain and spinal cord. If the cells do not migrate, it needs to be injected into where it can do the most good (i.e. bridge the injury site). If the cells can migrate across the blood brain barrier, it is possible to inject the cells intravenously and expect the cells to get into the spinal cord.

    What will be the most likely treatment method (say for stem-cells)? Will it be surgery? Or will it be injections? Which could be better than the other and vice versa?
    • Tarcisio Barros (Brazil) employed the interesting method of injecting bone marrow stem cells into the artery supplying the spinal cord. Hongyun Huang (Beijing) injects OEG cells into the spinal cord surrounding the injury site. Carlos Lima and his group apparently cut out part of the spinal cord at the injury site and places a piece of nasal mucosa. The Russians, I believe, have been injecting the cells right under the pial surface of the spinal cord. So, there are many ways of getting the cells into the spinal cord and the route depends on the cells. In China, they have been injecting bone marrow stem cells intrathecally (into the cerebrospinal fluid space around the cord). There are some groups (but I don't think that they have any evidence that this works) who inject umbilical cord blood intravenously. A Korean group implants umbilical cord blood directly into the spinal cord.

    Are there any obstacles today when it comes to techniques and procedures for doing stem-cell placements in the cord? And what could those problems be?
    • Obviously, the more invasive the surgery, the more expensive the procedure and the more likely that extensive clinical trials will be required to show effects. But, I think that there has now been sufficient experience with all the major routes of implanting cells into the spinal cord that clinicians can choose a variety of approach. We need more experience to find out which ones are better.

    Wise.

  9. #9
    Senior Member
    Join Date
    Jun 2005
    Location
    Norway
    Posts
    17,427
    Yes I by errors I meant injured area. - Thank you for explanation and good answers.

    Leif

  10. #10
    Senior Member
    Join Date
    Jun 2005
    Location
    Norway
    Posts
    17,427
    One more. Dr.Young.

    I might be a bit out of the subject here, but any way.

    As I understand so fare;

    1.
    There is no proven therapy for restoring an (chronic) injured spinal cord at this moment of time. I understand that there are a few varieties of attempts for dealing with such issues around the world. Some are also a bit speculative I think (cutting out parts of the spinal cord at the injury site). Some clinics also may be in the business just for the money and not for the cure. Above I believe that the most of them are doing a great job out there and trying to deal with SCI therapy issues as best they can – which are great.

    So, what can I do as a single person for matters like this? I believe I only can try to be as best updated I can. Follow the debate out on internet and other forums.

    2.
    Techniques and routes for implanting cells to the spinal cord; as you write there are several options here. I also believe so. Many of the already established surgical procedures and methods for dealing with spinal cord problems and injuries can be used.

    So, what can I do as a single person here? I guess nothing, and better stay out of the way.



    What can I do as a single person?

    In relation to the above; I believe as a single person and something all of us can do is to put more pressure on our politicians though I believe what we need here is much more money and funding for the stem cell research. I also believe that we have to put more pressure on our politicians to remove bans and legislations that slows down stem cell research. Like the US the Norwegian law makers has also put a ban on embryonic stem cell research. The government funding is also close to zero. I believe all this is the major problem for seeing a possible cure.

    What I like to do here is to write letters to all of the Norwegian political parties (this is also a good time for doing such a thing, due to the Norwegian parliament is up for new elections in September). I would liked to write a letter containing facts about what kind of research is going on around the world, some discussions about the ethics because that is a major and misunderstood bottleneck. Some writing about funding should also be described and discussed in such a letter.

    My question is; is there a pre-written letter regarding such issues here on this website I can use and translate to Norwegian for usage. If there is, I am a little bit afraid that such a prewritten already existing letter can be a bit out of date.

    Is there a possibility for that you can write such a letter when you have time (if you don’t mind) and post on this site, and you can write it as if you wanted to write it say to an American congressman, because I believe the political situation in the US is similar to the Norwegian when it comes to stem cell research? I and peoples from other countries can just translate it and send it in our own names (this is important, we have to use our own names). And if you write it, it will be up to date when it comes to the current situation dealing with facts etc.

    I’m not a medical expert, that’s why I’m asking. Any way I have a suggestion for such a letter. This is just how I see it.

    a)
    It should start with; Dear politician or congressman or in a form as “to whom it my concern”.

    b)
    The subject of the letter must be stated, meaning the need for funding and laws that will benefit the stem cell research.

    c)
    The letter should contain a brief situation description on what is going on around the world when it comes to stem cell research and therapies and the possibility for new therapies.

    d)
    It should also describe the current situation and environment for western scientists dealing with “pure research” on stem cells. Both human stem cells and embryonic stem cell research.

    e)
    A section in the letter must also contain some ethical issues. How we are doing now, the throwing away of blastocysts etc. A clarification on the ethical debate are required in the letter, because I believe a lot of misunderstandings and the fact that many don’t (among me) know what is going on when it comes to stem cell research and what is required. Especially politicians I believe. I believe the ethical section is important, because many politicians that are against such research just refers to some ethical issues and then they are off the hook. What about the issue of doing nothing for finding a cure for SCI peoples?

    f)
    A section with the opportunities that lays here; the possibility for future jobs and earnings etc.

    g)
    May be a section describing the current terrible situation SCI peoples are in. The long term care we need, all the medications required, the amount of care givers required for each individual.

    h)
    Any good ideas.



    If this can be done I would be grateful. If you don’t have time to draft such a letter I will try to do it in my own. I will also send such a letter not only to politicians, but also to all major newspapers and TV-channels over here.



    Thank you again,

    Leif


    Any good ideas are appreciated.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •