Spinal Cord Injury: Treating Paralysis
Spine Specialists On-Call: Paralysis - How Close Are We to Walking Again?
During the acute phase of paralysis, steroids are used to reduce inflammation. Inflammation is one of the body's first responses to injury. Other medications may include nerve growth factors to encourage nerve regeneration (regrowth).
Treatment in a rehabilitation center is geared to help the patient 'maximize' their ability to function and to prevent complications that typically occur with SCI. Complications may include pneumonia, difficulty breathing, low blood pressure, bladder and bowel issues, pressure sores, and spasticity.
All of the patient's needs are efficiently handled by a rehab staff that is trained to work as a team. Rehab often includes occupational therapy, physical therapy, and nursing.
Research into paralysis and restoring function (motor and sensory) is encouraging. One area of research is stem cells. Stem cells use the patient's own immune system to help repair spinal cord injury (activated macrophages).
Special devices have been developed to help SCI patients improve and maintain their ability to function. These devices include phrenic nerve pacemakers and Functional Electrical Stimulation (FES) systems.
Phrenic Nerve Pacemakers
These devices are also called breathing pacemakers. For some patients, these devices provide freedom from a ventilator.
These electrical stimulation systems are being developed and tested to facilitate and regulate bladder and bowel function.
Advancements in Physical Medicine and Rehabilitation
There have been some very promising developments in the field for the rehabilitation of patients with SCI. One such treatment is weight-assisted ambulation. The patient is placed on a treadmill and with the assistance of therapists, is re-trained how to walk. The hope is that this will capitalize on the ability of the spinal cord itself to learn motor patterns.
Some patients are candidates for tendon transfers that allow for improvement in arm or leg function. Plus, there are implantable nerve stimulators to stimulate nerves to improve the muscle firing in an arm. In addition, devices are available to allow patients to activate their paralyzed limbs for aerobic exercise.
Can Paralysis be Cured?
No one can know for sure where current developments and research will lead. As Christopher Reeve stated in his biography, "When JKF said in the early 60s he wanted to send someone to the moon that decade, there were many doubters. So there is no telling what the next few years can bring us."
We really can't answer that question now. However, we are optimistic and persevere in our research. In the meantime, the focus of our work is to continue to provide the best care and rehabilitation management to our patients coping with SCI.