Mini Medical School
Back to the Future: Experimental Spinal Procedures Promising
INDIANAPOLIS - The spinal cord is a maze of nerves extending from the base of the brain to the waist. Enclosed within the backbone, the cord carries complex electrical signals to and from the brain. If the power supply along the cord is cut or disrupted seriously enough, so too can a person's ability to walk, to control the bladder and bowels, to feel the touch of another's hand, to scratch an itch - and to breathe.
Each year, more than 11,000 Americans, overwhelmingly male and under
the age of 30, suffer spinal cord injury, leaving them paralyzed or seriously
disabled and with little hope of recovery. Humans have many capabilities
but restoring the electrical power supply that controls everyday body
functions and movements is not on that list.
"Mammals, most notably humans, stand alone in the world of vertebrates
as not having the capability of naturally regenerating spinal cord nerve
processes that have been damaged," said Scott Shapiro, M.D., professor
of neurosurgery at the Indiana University School of Medicine, speaking
at the Nov. 13 session of Mini Medical School. "Most spinal cord
injuries involve the crushing and not the severing of the cord. The crushing
leads to cell death and separation of nerve fibers, and when fibers separate
and the electrical impulses stop, paralysis sets in."
Dr. Shapiro, who also is chief of neurosurgery at Wishard Memorial Hospital,
is leading the first human clinical trial to test whether weak electrical
fields applied to spinal cord injuries can help regenerate nerve fibers
to promote some functional recovery to patients. The electricity comes
from the cigarette lighter-sized extraspinal oscillating field stimulator,
surgically implanted over the injured area.
Six patients have undergone the procedure at the IU School of Medicine
since the trial got under way. The trial is open to patients between the
ages of 18 and 65 who have sustained a complete motor spinal cord injury.
Patients must be entered into the trial within three weeks from the time
of their injury.
The trial, which began in mid-2001 following approval by the Food and
Drug Administration, is based on research and treatment of spinal-injured
dogs pioneered and developed at the Purdue University Institute for Applied
Neurology. One canine suffering from a disk herniation was paralyzed in
its hindquarters. The dog was wagging its tail and climbing stair steps
within six months of receiving the implant.
Will the stimulator device work in humans? "It's too early to tell,
Dr. Shapiro said. "Certainly it's a novel approach, but it's only
a start."
Another promising approach to treat spinal cord injury is the use of
a polymer commonly used in cosmetics, toiletries and medicine. Polyethylene
glycol is a water-soluble waxy substance that has been shown to repair
damaged nerve membranes in guinea pigs.
"PEG appears to fuse the membranes of nerve cells that have been
damaged," said Dr. Shapiro, adding that some researchers believe
the polymer might one day be used to reduce or reverse damage to nerve
cells that causes paralysis.
Dr. Shapiro's appearance was the final session of a six-week series of
the fall Mini Medical School. Participants met each Tuesday night to hear
from IU School of Medicine's leading physicians and researchers.
Mini Medical School is partly funded with a $10,000 educational grant
from Pfizer Pharmaceuticals Group. Three Indianapolis-area high schools
- Lawrence Central, North Central and Zionsville - each received $250
checks for sustained student attendance during the fall series. The money
will be used for in the schools' science programs.
Additional support for Mini Medical School comes from WIBC-AM radio in
Indianapolis, and IU Medical Group, which is offered by the Indiana University
School of Medicine Faculty Community Relations Committee through the IUPUI
Division of Continuing Studies.
The next series of Mini Medical School begins Feb. 12, 2002. For more information about dates and scheduled presentations, see www.medicine.indiana.edu/mini_med/spring_02.html. For registration information, call 317-278-7600.
Web Sites of Interest
IU School of Medicine-Section of Neurosurgery
www.iupui.edu/~neurosur
IU Head and Spinal Cord Injury Center
www.medicine.indiana.edu/news_releases/archive_00/nra00.html
National Spinal Cord Injury Association
www.spinalcord.org
Christopher Reeve Paralysis Foundation
www.paralysis.org
Media Contact: Joe Stuteville
317-274-7722
jstutevi@iupui.edu
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