Acute spinal cord injury case study

Nursing home admission is more common among elderly persons. There is no difference in the rate of re-admissions between persons with paraplegia and quadriplegia, but there is a difference between the rate for those with complete and incomplete injuries. Causes of Death The most common cause of death is respiratory ailment, whereas, in the past, it was renal failure.

Acute spinal cord injury case study

This story, originally printed in the September issue of Scientific American, is being posted due to a new study showing that nerve cells can be regenerated by knocking out genes that typically inhibit their growth.

For Chinese gymnast Sang Lan, the cause was a highly publicized headfirst fall during warm-ups for the Goodwill Games. For Richard Castaldo of Littleton, Colo.

Whatever the cause, the outcome of severe damage to the spinal cord is too often the same: Ten years ago doctors had no way of limiting such disability, aside from stabilizing the Acute spinal cord injury case study to prevent added destruction, treating infections and prescribing rehabilitative therapy to maximize any remaining capabilities.

Acute spinal cord injury case study

Nor could they rely on the cord to heal itself. Unlike tissue in the peripheral nervous system, that in the central nervous system the spinal cord and brain does not repair itself effectively.


Few scientists held out hope that the situation would ever change. Then, ina human trial involving multiple research centers revealed that a steroid called methylprednisolone could preserve some motor and sensory function if it was administered at high doses within eight hours after injury.

For the first time, a therapy had been proved to reduce dysfunction caused by spinal cord trauma. The improvements were modest, but the success galvanized a search for additional therapies.

Since then, many investigators—including us— have sought new ideas for treatment in studies of why an initial injury triggers further damage to the spinal cord and why the disrupted tissue fails to reconstruct itself.

In this article we will explain how the rapidly burgeoning knowledge might be harnessed to help people with spinal cord injuries. We should note, however, that workers have also been devising strategies that compensate for cord damage instead of repairing it.

In the past two years, for example, the U. Food and Drug Administration has approved two electronic systems that regulate muscles by sending electrical signals through implanted wires. One returns certain hand movements such as grasping a cup or a pen to patients who have shoulder mobility; another restores a measure of control over the bladder and bowel.

A different approach can also provide grasping ability to certain patients. Surgeons identify tendons that link paralyzed forearm muscles to the bones of the hand, disconnect them from those muscles and connect them to arm muscles regulated by parts of the spine above the injury and thus still under voluntary control.

Further, many clinicians suspect that initiating rehabilitative therapy early—exercising the limbs almost as soon as the spine is stabilized—may enhance motor and sensory function in limbs. Those perceptions have not been tested rigorously in people, but animal studies lend credence to them.

The Cord at Work The organ receiving all this attention is no thicker than an inch but is the critical highway of communication between the brain and the rest of the body.

The units of communication are the nerve cells neuronswhich consist of a bulbous cell body home to the nucleustrees of signal-detecting dendrites, and an axon that extends from the cell body and carries signals to other cells.

Axons branch toward their ends and can maintain connections, or synapses, with many cells at once. Some traverse the entire length of the cord. The soft, jellylike cord has two major systems of neurons.

The descending pathways begin with neurons in the brain, which send electrical signals to specific levels, or segments, of the cord. Neurons in those segments then convey the impulses outward beyond the cord.

The other main system of neurons— the ascending, sensory pathways—transmit sensory signals received from the extremities and organs to specific segments of the cord and then up to the brain.

The cord also contains neuronal circuits such as those involved in reflexes and certain aspects of walking that can be activated by incoming sensory signals without input from the brain, although they can be influenced by messages from the brain.

The cell bodies in the trunk of the cord reside in a gray, butterfly-shaped core that spans the length of the spinal cord. The ascending and descending axonal fibers travel in a surrounding area known as the white matter, so called because the axons are wrapped in myelin, a white insulating material.

Both regions also house glial cells, which help neurons to survive and work properly.

Acute spinal cord injury case study

The glia include star-shaped astrocytes, microglia small cells that resemble components of the immune system and oligodendrocytes, the myelin producers. Each oligodendrocyte myelinates as many as 40 different axons simultaneously.

The precise nature of a spinal cord injury can vary from person to person.Asterias Biotherapeutics is a micro-cap biotechnology company that is focused on cell-based therapies for spinal cord injuries and broad cancer.

Clinical trials thus far in OPC1 and VAC1 have. Repairing the Damaged Spinal Cord. Once little more than a futile hope, some restoration of the injured spinal cord is beginning to seem feasible.

Abstract. Spinal cord injuries (SCIs) often lead to impairment of the respiratory system and, consequently, restrictive respiratory changes. Paresis or paralysis of the respiratory muscles can lead to respiratory insufficiency, which is dependent on the level and completeness of the injury.

NIDRR Model Spinal Cord Injury Systems The thirteen SCI rehabilitation programs listed below are designated as Model Systems by the National Institute of Disability and Rehabilitation Research (NIDRR). Articles Scroll down to see all conditions, or select one below: Cerebral Palsy - Vegetative State, Minimally Conscious State, and Locked-In Syndrome - Traumatic Brain Injury and Anoxic Brain Injury - Spinal Cord Injury - Autism - Down Syndrome - Comparative Mortality (Placement Of The Developmentally Disabled) - Epilepsy - Medical Conditions and Other Topics.

In contrast to the old guidelines, a recommendation in the chapter "Pharmacological Therapy for Acute Spinal Cord Injury" is that methylprednisolone (MP) not be used for the treatment of acute SCI.

Spinal Cord Injuries