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Experimental Treatments for Spinal Cord Injury

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The medical community is always researching better ways to treat patients. With spinal cord injury (SCI), there are several challenges that doctors and researchers are working to resolve. Some of them are:

  • immediate post-spinal cord injury care
  • preservation of motor and sensory functions
  • minimizing complications
  • restoring function.

Additionally, special devices and certain drugs are under investigation, and some of them show promise for improving SCI treatments.

Some of the questions experts are striving to answer revolve around spinal cord injury repair and regeneration—of which stem cell research is a part.

  • Spinal cord nerve cell death: Why does this happen and is cell replacement possible?
  • Nerve pathway disruption: How to reconnect and / or regenerate axons (neuronal cells, long nerve fibers) that conduct electrical impulses?
  • Loss of axon insulation (demyelination): Myelin sheaths insulate axons. How can myelin be replaced?

Stem cell research is especially interesting. A stem cell is a cell with the potential to develop into different types of cells such as a muscle, nerve, blood, or brain cell. For stem cells to be useful, they must be able to reproduce in sufficient numbers, develop into the desired cell type, survive transplantation, and function without harm throughout a lifetime.

Right now, there's one particular area of stem cell research that is encouraging for SCI patients: researchers are looking into stem cells becoming part of the body's repair system.

Therapeutic Hypothermia
Therapeutic hypothermia, or medically lowering body temperature, has been shown to help patients after cardiac arrest and brain trauma. Cooling the body (or body part) slows circulation, reduces inflammation, and may control damage from injury (e.g., bleeding).

Therapeutic hypothermia has been used after spinal cord injury. Therapy may be administered using ice packs, surface heat-exchange device and ice, special cooling helmet, via catheter, and infusion of cold fluids.

Phrenic Nerve or Diaphragmatic Pacemaker
This treatment is experimental and used to help patients with spinal cord injury breathe. It is sometimes called electrophrenic respiration. This device freed Christopher Reeve from his ventilator.

The phrenic nerve branches off the spinal cord near C4 and goes to the diaphragm and the membrane around the heart (pericardium). A phrenic pacemaker stimulates the phrenic nerve to help pace breathing and improves respiration. Instead of a ventilator forcing air into the lungs, a phrenic pacemaker enables the diaphragm to contract and allows the patient to inhale more naturally.

Functional Electrical Stimulation (FES)
FES uses electrical current to activate nerves affected by paralysis. It is used to stimulate functions such as motor control, walking, arm and upper body movement, and urination. Stimulation can help prevent or manage pressure sores, provide chest and abdominal movement necessary for breathing / ventilator assistance, encourage return of movement, and control spasticity.

Parastep® System
This ambulation assistance system is combined with FES. It is approved by the US Food and Drug Administration. Parastep helps patients stand and walk without bracing and helps them become more independent. It is a functional neuromuscular stimulation system controlled by a microcomputer. Stimulation is routed through skin electrodes.

Studies and Clinical Trials
To learn about all clinical trials currently being conducted on spinal cord injury treatments, please visit the US government's clinical trial page.

Updated on: 12/10/09
Edward C. Benzel, MD
This article was reviewed by Edward C. Benzel, MD.
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