The Incredible Science Transforming Spinal Cord Injury Treatment

August 2, 2018

in

Personal Injury

by

Dr. Ben Janaway

In The Empire Strikes Back, Luke Skywalker battles Darth Vader and loses a hand. And, for Luke, like many others, the loss of a limb or its use is devastating. And that is exactly what  a spinal injury cord can do. New technology may help us build new hands, or even grow new nerves. And with that, novel spinal cord injury treatment is about as sensational and futuristic as you can imagine. Brainwave detectors, gene doctoring and exoskeletons are on the way.

Spinal Cord Injury and Paralysis

The spinal cord, a complex bundle of nerves, is your information superhighway. It transports data about sensation, location and bodily function from the organs and limbs to the brain and sends signals for movement, coordination and reflexes back. Spinal cord injuries (SCI) can cause many symptoms, ranging from death or complete paralysis to patchy loss of sensation, weakness, loss of bladder control and mal-coordination. And these symptoms may be permanent, as once a neuronal cell is gone, it is extremely hard to bring it back. 

Worse still, SCI is on the rise, with estimates of 40-80 cases per million and up to 500,000 new cases a year. Current treatments include the use of drugs, signalling inhibitors, physiotherapy and surgery. Old treatment hopes to limit damage and symptoms but rebuilding what is lost awaits. And now doctors are turning to tech entrepreneurs and new thinking to solve the problem. The cure to paralysis has become big business.

Brainwaves, Bionics and Machines

Perhaps the most exciting development in paralysis treatment is the use of robotics. Tech geniuses have designed 'exoskeletons' capable of replicating human movement.  Designers at SuitX created a modular skeleton worn on the legs and controlled using buttons on crutches, reaching speeds of 1.1mph.  But it doesn't stop there. Entrepreneurs at Rewalk have gone a step further, creating a suit that responds to body position. Just lean forward, and the suit will walk for you. 

‍Battery powered exoskeleton from SuitX is allowing spinal cord injury patients to walk again

But the next advancement is a positive leap forward.

Ground-breaking work by scientists means we can use brain waves to move again.  The team recorded a patients brain waves whilst asking him to 'think about' walking. Next he 'controlled' the movement of an avatar in a computer program. This data was fed into special electrodes in his legs, which when activated, stimulated muscle movement. By thinking about walking, he could do it. 

Finally, scientists may have solved the problem of feeling. An international team restored sensation to a prosthetic finger, showing that bionics can do just about anything.

 


Light sensors, stem cells and new life

Moving away from robotics, scientists have found ways to grow and control new nerve cells. By ingeniously using proteins responsive to light, researchers have been able to turn cells off and on. In nerve circuitry, it is both the connections and order of activation that matter, and the use of Optogenetics gives you precise control over the latter. By injecting proteins into nerve cells researchers have been able to stimulate cell activity using light. The cell responds to only certain light wavelengths, meaning that nerve pathways can be executed in order. 

Scientists publishing in the Journal of Neuroscience showed that the technique can restore breathing function after paralysis. Further work published in The Spine Journal demonstrates that photostimulation can begin to restore bladder function.  The technique proves that neuronal cells can be controlled, which means that movement may also be restored. But this only works if you have living cells.

The use of Stem Cells is leading the way in restoring dead cells. These cells, harvested from the patient, can be coerced to develop into whatever cell we choose.  Including nerve cells. And not only can we develop nerve cells, but these cells may be able to reconstruct neural circuitry and restore limb function. Scientists injected neural stem cells into paralysed rats, noting that the cells created new links with local nerves. And the most surprising, using optogenetics means we can activate these new cells remotely.

An incredible real life example of stem cell research showing progress is the results of a clinic trial at the Keck School of Medicine USC (University of Southern California). Just before turning 21, Kris Boesen (pictured below) was seriously injured in a car accident. As a result of the accident, Kris was paralysed from the neck down. However, he was lucky to qualify for a clinical trial and a few weeks after the accident, had 10 million AST-OPC1 cells directly into his cervical spinal cord. Within just 4 days Kris was able to hold a smartphone and send a text on his own. In the weeks that followed, more strength and control returned to his arms allowing him to feed himself, use a computer and lift weights.

Kris Boesen was left a quadriplegic following a horrific car accident. He’s now regained use of both arms following a stem cell clinical trial.‍

The Next Steps

With incredible strides in robotics, genetics and biology, tech geniuses are working hand in hand with doctors to fight paralysis. The integration of robotics, mind controlled electrodes, stem cells and optogenetics could create fully mechanic, biological or augmented solutions for SCI. Imagine a world where you could regrow the nerves in your hand, and use your brain to move them again. Or to activate light diodes and power optogenetic nerves so you can feel you partners hand again.

We still have a way to go, but the future promised in Star Wars isn't in a galaxy far away, it's almost at your fingertips. 

Disclaimer.The information presented here is limited by the constraints inherent in the research consulted. Any treatment or therapy must be discussed with your physician. Smith's Lawyers takes no responsibility for limitations of, or on, the treatment described above. Contact Dr Janaway for discussion.

Dr. Ben Janaway
Rebecca Earl

Doctor | Writer | Science Communicator | Activist

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