There are estimated to be 1,275,000 persons with paralysis due to spinal cord injuries in the United States (Angeli et al., 2018) Spinal cord injuries can be very debilitating and often times lead to some form of paralysis. These types of injuries can rob people of mobility who once led very active lives. Thankfully, science has come a long way and has had some recent breakthroughs. Treatments have been very limited in the past, primarily consisting of physical therapy. We now have access to many more options such as electrode therapy, injectable nanofiber-hydrogel composites (NHC), and stem cell implantations. These forms of therapy have shown amazing results on their own. In some cases these forms of therapy have resulted in the mobility of a patient who had originally lost their mobility due to spinal cord injuries. In this post I will be explaining the different therapies I have previously mentioned and their ability to help cure paralysis. Some of which are mechanical support therapies and some of which are electrical and biological. I truly believe that combining these therapies can result in a cure for paralysis. One can certainly be hopeful.
In 2020 a team of researchers were focusing on spinal cord injuries and what could be done to help these patients. Xiowei Li et al, were testing the effects of NHC on rats to determine if this injectable composite could assist the spinal cord injury site and even begin to repair the neuronal damage as well as the damage to surrounding blood vessels. The injectable composite showed results of mechanical support in the area of injury. NHC also showed results of increased angiogenesis and neurogenesis compared to controls. Li et al explain,
The use of injectable hydrogels represents a particularly promising avenue for treatment of the contused spinal cord, as they can effectively fill the lesion cavity, thereby allowing for increased compatibility between the hydrogel and native tissue. Also, hydrogels can imitate biological features of native extracellular matrix (ECM) which may facilitate tissue regeneration and repair. (Li et al., 2020)
This breakthrough in injectable composites being used as treatment for spinal cord injury is extremely vital to the ongoing search for a cure in paralysis. Although the aim of this study was to test NHC effects on the spine in rats, I believe it can be paired with other forms of treatment to bring us closer to a cure for paralysis in humans.
In a separate article titled, How a Breakthrough Therapy Helped Two Paralyzed People Walk Again—Years After Their Injuries, researchers in 2018 discovered a relatively new form of therapy involved with electrodes being implanted directly to the site of injury paired with a spinal cord stimulator implanted surgically in the anterior abdominal wall. After an allowed period of time for healing after surgery they began to run tests by pairing electromyographic recordings with electrical stimulation via the epidural nodes. "We report the recovery of intentional walking over ground with programmed epidural spinal cord stimulation coupled with intense locomotor training in two of four persons who had chronic motor complete cervical or thoracic spinal cord injury. Walking had not been achieved with weight-supported locomotor training alone and was possible only when the stimulator was on and the patient intended to walk." explains Angeli et al. This form of treatment was a success for two out of the four participants which is significant.
These treatments are very different from each other however they both show results that are significant and can be used to help people with these devastating injuries. This gives hope that we are closer to a cure for paralysis than we may think. I believe that if these treatments were to be paired with biologics such as stem cells that maybe we will begin to see neurogenesis and angiogenesis around the sites of injury that we may have never seen before. Whatever the case may be, we have come a long way in recent years and for the first time we have evidence of cures for paralysis.
References
Angeli, C. A., Al., E.,
Training and Outcomes in Two Participants (02:59), Author AffiliationsFrom
the Frazier Rehabilitation Institute (C.A.A., Training and Outcomes in Two
Participants (02:59), Others, P. M.-H. and, Others, J. S. and, Others, L. L. H.
and, S. A. Madhi and Others, Cypess, A. M., & A. Maqsood and L. R. Imel.
(2018, March 4). Recovery of over-ground walking after chronic motor
complete spinal cord injury: Nejm. New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMoa1803588?query=featured_home
Li, X., Zhang, C., Haggerty, A. E., Yan, J., Lan, M., Seu, M., Yang, M., Marlow, M. M., Maldonado-Lasunción, I., Cho, B., Zhou, Z., Chen, L., Martin, R., Nitobe, Y., Yamane, K., You, H., Reddy, S., Quan, D.-P., Oudega, M., & Mao, H.-Q. (2020). The effect of a nanofiber-hydrogel composite on Neural Tissue Repair and regeneration in the contused spinal cord. Biomaterials, 245, 119978. https://doi.org/10.1016/j.biomaterials.2020.119978
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