Injection Of Brain Nerve Cells Into Spine Helps Paralyzed Man Walk

BBC News reports that a paralysed man has been able to walk again after a pioneering therapy that involved transplanting cells from his nasal cavity into his spinal cord.

BBC One’s Panorama programme had unique access to the project and spent a year charting the patient’s rehabilitation.

Darek Fidyka, 40, from Poland, was paralysed after being stabbed repeatedly in the back in the 2010 attack.

He said walking again – with the support of a frame – was “an incredible feeling”, adding: “When you can’t feel almost half your body, you are helpless, but when it starts coming back it’s like you were born again.”

Cell Transplantation Journal – Functional regeneration of supraspinal connections in a patient with transected spinal cord following transplantation of bulbar olfactory ensheathing cells with peripheral nerve bridging

Before the treatment, Mr Fidyka had been paralysed for nearly two years and had shown no sign of recovery despite many months of intensive physiotherapy.

Six months after surgery, Mr Fidyka was able to take his first tentative steps along parallel bars, using leg braces and the support of a physiotherapist.

Two years after the treatment, he can now walk outside the rehabilitation centre using a frame.

He has also recovered some bladder and bowel sensation and sexual function.

Steps in the Procedure

1) One of the patient’s two olfactory bulbs was removed and the olfactory ensheathing cells (OECs) were grown in culture

2) 100 micro injections of OECs were made above and below the damaged area of the spinal cord

3) Four strips of nerve tissue were placed across an 8mm gap in the spinal cord. The scientists believe the OECs acted as a pathway to stimulate the spinal cord cells to regenerate, using the nerve grafts as a bridge to cross the severed cord

Abstract: Functional regeneration of supraspinal connections in a patient with transected spinal cord following transplantation of bulbar olfactory ensheathing cells with peripheral nerve bridging

Treatment of patients sustaining a complete spinal cord injury remains an unsolved clinical problem because of the lack of spontaneous regeneration of injured central axons. A 38-year-old man sustained traumatic transection of the thoracic spinal cord at upper vertebral level Th9. At 21 months after injury the patient presented symptoms of a clinically complete spinal cord injury (American Spinal Injury Association class A-ASIA A). One of the patient’s olfactory bulbs was removed and used to derive a culture containing olfactory ensheathing cells and olfactory nerve fibroblasts. Following resection of the glial scar the cultured cells were transplanted into the spinal cord stumps above and below the injury, and the 8 mm gap bridged by 4 strips of autologous sural nerve. The patient underwent an intense pre- and post-operative neurorehabilitation program. No adverse effects were seen at 19 months postoperatively, and unexpectedly, the removal of the olfactory bulb did not lead to persistent unilateral anosmia. The patient improved from ASIA A to ASIA C. There was improved trunk stability, partial recovery of the voluntary movements of the lower extremities, and an increase of the muscle mass in the left thigh, as well as partial recovery of superficial and deep sensation. There was also some indication of improved visceral sensation and improved vascular autoregulation in the left lower limb. The pattern of recovery suggests functional regeneration of both efferent and afferent long-distance fibers. Imaging confirmed that the grafts had bridged the left side of the spinal cord, where the majority of the nerve grafts were implanted, and neurophysiological examinations confirmed the restitution of the integrity of the corticospinal tracts and the voluntary character of recorded muscle contractions. To our knowledge, this is the first clinical indication of beneficial effects of transplanted autologous bulbar cells.

Other Spinal Repair Progress

China will probably have 1 million people with spinal cord injury in 2020 (80,000 per year). One third of the spinal cord injury people in the world. The US has about 10,000 spinal cord injury patients per year. There are surgical therapies that are restoring mobility to full spinal cord injuries and to get past the myths about the state of medicine in China.

Paralysis may no longer mean life in a wheelchair. A man who is paralysed from the trunk down has recovered the ability to stand and move his legs unaided thanks to training with an electrical implant. A 16-electrode array implanted into the lower region of his spinal cord, which stimulated spinal nerves with continuous electrical activity and training helped to restore function.

Swiss scientists severed the spinal cords of a half-dozen rats and then implanted flexible electrodes into the lower part of their spinal cords. The animals were also given a type of drug known as a serotonin agonist, which Courtine says readies the spinal cord to communicate with the legs, an ability that’s depleted after an injury. With their weight supported by a harness, the rats were placed on a treadmill or on a runway with obstacles.

This spring, doctors and researchers from the University of Louisville and the University of California, Los Angeles, said four men who had been paralyzed for years were able to regain movement in their legs, hips, ankles, and toes, and even stand using an implanted device that stimulated their spinal cords, a technique called epidural stimulation.

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