Over the years many methods have been used in an attempt to restore function in a person who’s suffered an SCI. Not all have been effective, but wireless technology might be the key.
An SCI results in permanent and usually irreversible damage to the spinal cord. This has catastrophic neurological consequences, including paralysis at varying levels (paraplegia to quadraplegia), loss of bladder and bowel control, alteration of sexual function, pain, spasticity, and loss of normal sensation.
Not to mention the psychological strain placed on the individual and their family post-injury. Scientists and researchers have always looked into the possibility of reversing the damage done in the acute injury phase and possible ways of repairing the damaged spinal cord.
Back in the 1980s, the focus was on preventing secondary damage by reducing any compression of the cord with surgery or early reductions of dislocations. (This is still an important consideration.)
At one time it was believed that very high doses of steroids altered the way the cord responded to trauma. This was believed to possibly reduce secondary damage through swelling. This has now been disproved and these large doses of steroids are no longer used in the acute injury phase. More recently, in the late 1990s, the use of stem cells from non-human sources was believed to be beneficial.
Stem cells in the body can divide and become differentiated. When an organism grows, stem cells specialise and take specific functions. Initially stem cell therapy was offered as a wonder cure for SCIs, and many people around the world spent a lot of money on stem cell transplants from animals such as sharks.
Unfortunately, these treatments have shown to have had no value and could be potentially harmful. Now, stem cells taken from the patient’s own body (olfactory ensheathing cells or umbilical cord cells) have been used to try and repair the spinal cord at the site of the injury.
Although animal models have shown some promise, there is no hard evidence that it is safe or that it can reverse serious injuries. There are, however, still people who attempt these therapies.
More recently, funds have been made available through various research foundations to look at alternatives to stem cells (although research in stem cells continues).
For example, it has been found that wireless devices can bridge the gap at the damaged cord, allowing the transfer of impulses through the device.
Research on animals and humans involving implanted wireless devices has given some hope: in some case studies in the US patients who have had these wireless devices implanted into the injured area have had some function return in a once-paralysed limb.
This research is still at the early stages, but it is hoped that with the rapidly developing age of wireless technology, these devices will offer a better chance at some recovery and restoration of quality of life in SCI than stem cells.
Dr Ed Baalbergen is the medical officer at the Vincent Pallotti Rehabilitation Centre (Cape Town) and is a member of the International Spinal Cord Society and the Southern African Neurological Rehabilitation Association. email: ed.baalbergen@lifehealthcare.co.za
