Pioneering surgery allows paralysed man to walk again

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A man who suffered complete paralysis from the waist down is able to walk again after a surgical breakthrough which offers millions of people disabled by spinal cord injuries renewed hope.

Polish surgeons made use of nerve-supporting cells from the nose of a Bulgarian man, Darek Fidyka, to provide pathways for the broken tissue to grow.

He is believed to be the first person in the world to recover from completely severing his spinal nerves. He is now able to walk with a frame and it has offered him an independent life. He may also be able to drive a car as sensation has been restored in his lower limbs.

Professor Geoffrey Raisman, who headed the team at University College London’s institute of neurology responsible for the discovery of this technique, said they believe this procedure is the breakthrough which, on further development, will result in a historic change in the existing hopeless outlook for those disabled due to spinal cord injury.

The surgical procedure was performed by a Polish team who was led by one of the top spinal repair experts globally, Dr Pawel Tabakow, based at Wroclaw Medical University. It involved the transplantation of olfactory ensheathing cells (OECs) from the nose of the patient to his spinal cord.

OECs assist in the repair of damaged nerves which transmit smell messages by opening pathways for it to the olfactory bulbs within in the forebrain.

When relocated to the spinal, they seem to enable the ends of severed nerve fibres to grow and fuse. This process was previously thought to be impossible.

The team took cells from the olfactory bulbs in the patient’s brain and grew them in the laboratory. These cells were later injected into the spinal cord below and above the damaged area. Thereafter nerve fibre strips were taken from the ankle of the patient to form a bridge for the cells to grow across.

Although there are patients who have suffered a partial spinal injury who have made incredible recoveries, it is generally assumed that a complete break cannot be repaired.

Raisman is hoping that at least three more patients can be treated in Poland over the next three to five years, provided funding can be raised. He said that the patient is currently able to move around his hips and on his left side he has experienced leg muscle recovery. He is able to move about with a walker and has been able to resume much of his previous life, including being able to drive a car. Raisman said the patient is not dancing, but he is delighted about his status.

The research, which received funding from the Nicholls Spinal Injury Foundation (NSIF) and the UK Stem Cell Foundation, will be featured in a BBC Panorama programme to be aired on Tuesday night.

The founder of NSIF, David Nicholls, whose son Daniel was paralysed during 2003, said this information will become available to other researchers across the globe to help in the cure of paralysis.

He said most people are unaware of the consequences of paralysis as they are not affected by it. He said that it is a devastating experience for a parent to watch their son or daughter lying motionless in bed and not know if they will ever be able to walk again.

Raisman said he had never really believed the ‘observed wisdom’ that the central nervous system was unable to regenerate damaged connections. He said nerve fibres are constantly trying to regenerate, however, there are two problems – crash barriers, which are the scars, and a very large hole in the road.

He added that for the nerve fibres to express that ability, they have always had to repair themselves. The first step is for the scar to be opened, and then a channel that will show them the direction they need to go has to be provided.

He placed stress on the fact that what has recently been achieved was a massive leap forward, which goes beyond the promotion of ‘plasticity’; it is the rewiring of the remaining connections.

He added that there are millions of paralysed individuals worldwide and if the global neurosurgeon community can be convinced that this technique works, it will see rapid development.

Image Credit: warrenski

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