Repairing the Damaged Spinal Cord

Once little more than a futile hope, some restoration of the injured spinal cord is beginning to seem feasible















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Limiting an injury will be easier than reversing it, and so treatments for ameliorating the secondary damage that follows acute trauma can be expected to enter human testing most quickly. Of the repair strategies, promoting remyelination will be the simplest to accomplish, because all it demands is the recoating of intact axons. Remyelination strategies have the potential to produce meaningful recovery of function, such as returning control over the bladder or bowel— abilities that uninjured people take for granted but that would mean the world to those with spinal cord injuries.

Of course, tendon-transfer surgery and advanced electrical devices can already restore important functions in some patients. Yet for many people, a return of independence in daily activities will depend on reconstruction of damaged tissue through the regrowth of injured axons and the reconnection of disrupted pathways.

So far, few interventions in animals with well-established spinal cord injuries have achieved the magnitude of regrowth and synapse formation that would be needed to provide a hand grasp or the ability to stand and walk in human adults with long-term damage. Because of the great complexities and difficulties involved in those aspects of cord repair, we cannot guess when reconstructive therapies might begin to become available. But we anticipate continued progress toward that end.

Traditionally, medical care for patients with spinal cord injury has emphasized compensatory strategies that maximize use of any residual cord function. That focus is now expanding, as treatments designed to repair the damaged cord and restore lost function—science fiction only a decade ago—are becoming increasingly plausible.



ABOUT THE AUTHOR(S)

JOHN W. MCDONALD and the other members of the Research Consortium of the Christopher Reeve Paralysis Foundation have been collaborating since 1995. McDonald is assistant professor of neurology and rehabilitation at the Washington University School of Medicine and director of the Spinal Cord Injury Section at Barnes-Jewish Hospital in St. Louis. His co-authors are Aileen J. Anderson and Carl W. Cotman, University of California, Irvine; Ira B. Black, Robert Wood Johnson Medical School; Christian Broesamle, Isabel Klusman and Martin E. Schwab, University of Zurich; Mary Bartlett Bunge and Giles W. Plant, University of Miami School of Medicine; Dennis W. Choi, Washington University School of Medicine; Fred H. Gage and Philip J. Horner, the Salk Institute; Daniel J. Liebl and Luis F. Parada, University of Texas Southwestern Medical Center; and Chan Roonprapunt and Wise Young, Rutgers University.


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  1. 1. teresa pernell 07:25 PM 11/11/09

    The spinal cord is a very remarkabe instrument.Knowing that if you damage it you are pretty much in bad shape.It can not repair itself. Injuring the spinal cord could also paralyze the chest and lungs wow.

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  2. 2. Simple Simoon 01:02 AM 2/15/10

    This article discusses a lot of research involving spinal cord injuries. With the damage continuing after the initial injury, the impact of a spinal cord injury can be devastating. However, the diagnosis of MS, with the long term decline that is possible, would suggest that some research on repairing the scar tissue from demyelination would be appropriate as well. Lets pray that the research continues for both spinal injuries and multiple sclerosis.

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