Stem Cells: A New Way to Potentially Treat Spinal Cord Injuries
Jun 27, · Immobilizing the neck to prevent further spinal cord damage; Health care providers also may treat an acute injury with: Surgery. Doctors may use surgery to remove fluid or tissue that presses on thespinal cord (decompression laminectomy); remove bone fragments, disk fragments, or foreign objects; fuse broken spinal bones; or place spinal braces. 1. Mar 07, · If you've suffered a spinal cord injury, it is only natural for you to search out the latest breakthroughs in medicine and technology to find a treatment that can get you back to the way things used to be. And one promising branch of current medical research is in the direction of stem cell therapy.
Last Updated: January 2, References. This article was medically reviewed by Janice Litza, MD. Litza is a board certified Family Medicine Physician in Wisconsin. There are 20 veronica lake hair how to cited in this article, which can be found at the bottom of the page.
This article has been viewedtimes. Some injuries can cause damage to a person's spinal cord, treaat delicate nerve system in the neck and spine responsible for sensation and muscle movement. Spinal injuries are very serious and can lead to permanent disability, paralysis, or even death. In an emergency situation when the victim may have a spinal injury, you should avoid worsening damage to the spinal cord however possible.
Accidents happen, but knowing how to properly treat someone who has had or might have a spinal injury could save someone's life inury help prevent irreparable damage.
To treat a spinal injury victim, do not move them unless they are in immediate danger, since movement can cause permanent injuries. If you must move them, pull their body by their clothing in a straight line while bracing their head with your forearms.
You should also call right away if the person isn't breathing, and follow their instructions while you wait for the paramedics. Did this summary help you? Yes No. How to not worry about death in Social login does not work in incognito and private browsers.
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This is because the consequences of spinal injury are severe and usually permanent, and mistreating someone with a how to avoid another great depression injury — even if you have the best intentions — can seriously worsen the injury and outcome. Any victim with an dord to their head, neck or back should automatically be treated as if they have a spinal injury.
Diving into shallow water, for instance, may be an innjury source of spinal injury. Do NOT move ibjury victim. Any movement of the injured person can cause worse damage to their spinal cord. The only time you should ever move a potential spinal injury victim is if they are in immediate danger, such as in a burning house or car.
If you are both in a safe environment, leave them exactly where they are and allow medical professionals to move them. If the victim was wearing a helmet at how to treat a spinal cord injury time of injury, such as during sports or in a motorcycle accident, do not remove the helmet.
This should be done by professionals. Call for emergency services. Medical professionals will be better able to assess and manage potential spinal injuries, and will have backboards and special equipment for moving people with these injuries. Contacting emergency medical personnel should be done immediately, assuming you and the victim are in no immediate danger. When calling for medical aid, inform staff that you are dealing with a victim of a spinal injury.
They will be able to give you more advice on how to take care of the victim. Give CPR if necessary. Observe whether the victim is breathing on their own, as spinal injury can sometimes affect ability to breathe spontaneously. Look to see if their chest is rising with breath, or feel under their nose for air.
The only time you should move the victim's head — short of being in cordd peril — is if you have to provide the rescue breathing or chest compressions of CPR. This can be a life-saving measure until emergency medical care arrives.
If the victim's heart is beating but they are not how to relieve tension in neck causing headaches, provide rescue breaths; if they have no pulse, focus on high-quality chest compressions. To give rescue breaths, do NOT lift the victim's chin to open an airway if you can avoid it.
Instead perform what is called the Jaw Thrust rteat Kneel at the top of the victim's head, use both hands one on each side to hold corr angles of their lower jaw, and lift upward with both hands. Unfortunately, this requires a second person present to perform the rescue breathing while you hold the jaw upward. If they do not need CPR, you can then — without moving the victim — look them over to see if they have any other obvious severe injuries. Apply pressure to wounds that are heavily bleeding.
Note the cause of the injury. The most common cause of spinal injury in persons under age 65 is vehicular accidents. Other common causes are falls, gunshot and coed wounds, playing sports without appropriate safety equipment especially American footballand injury sustained while under the influence of alcohol.
It may also help crod staff if you can tell them what caused the injury. Recognize symptoms of spinal injury. If no healthcare professional is on site, you can evaluate the victim for signs and symptoms of spinal injury.
First observe the victim — if they are unconscious or only somewhat conscious, their neck or back is at a strange angle, or they have lost control of their bladder or bowels and soiled themselves, assume spinal injury.
Also treat them as if they have spinal injury if they won't or can't move their neck, seem to have trouble breathing, or they tell you they have intense pain in their neck, back or head. Another tell-tale sign of spinal injury is change in strength or sensation in their limbs. Depending on the location of the injury, the patient will be affected in all four limbs, only on one side of the body, or in some or only one limb.
Stabilize the victim until help arrives. Injufy the victim totally still until professional help arrives. Hold their head and neck to prevent them from moving until emergency care arrives. I'm here and professional help is on the way, but I need you to stay nice and still right now. Method 2 of Pull the victim by their clothing.
In a situation that absolutely requires you to move the victim, do it in the least damaging way possible. Grab their shirt collar and use your forearms to support their head while pulling the body in a straight line. This is a preferred method as the victim's head is braced while moving.
Pull the victim by their arms or legs. Alternately, hold the victim and pull them by both feet, both shoulders, or how to color your hair with henna properly arms pulled over their shoulders.
Do NOT pull by one arm or leg, as this will twist the body. Keep their neck and torso straight and pull them in a straight line. Do not pull the body sideways! Emergency medical staff immobilize the spine with a rigid neck collar and a carrying injjury. The goal is to minimize movement in the neck and spine as much as possible. If injury occurs in the water, keep the victim afloat until someone can obtain a rigid board to slide under their head and torso as far down as their buttocks.
If you can't get a board, get help from other people to get the victim out of the water by moving them as one unit. Support their head and body, as if on a stiff board, and don't let their neck bend or rotate. Use at least two people if you must roll the victim over. If you must roll a spinal injury victim over to prevent choking on blood or vomit, get a second person to help you. Coordinate your timing so that you roll the victim over in such a way that the neck, back, and torso move as one unit.
Do not allow the body to twist. Method 3 of Monitor injured victims for late signs of spinal injury. Though many victims of head or neck trauma experience immediate symptoms of spinal injury, this is not always the case. Sometimes there are no immediate signs but as bleeding and swelling put pressure on the spinal cord, symptoms develop. It's best to go to the hospital right after injury, but if not then seek immediate medical care if the injured person develops late symptoms of: Changes in sensory perception, like numbness and paralysis, which may worsen gradually.
New onset of erectile dysfunction or changes in genital sensitivity. Obtain diagnostic imaging. Ohw you or a loved one are at risk of spinal injury after an accident, go to the emergency room or at least see your doctor for spiinal.
Your family doctor can perform sensorineural testing, manually testing muscle strength and ability to feel light touch. Participate in ongoing rehabilitation. The injury victim of spinal trauma will initially be stabilized in the hospital.
Clinical trials using neural stem cells
Normally, treatment for a spinal cord injury involves extensive physical therapy and rehab. However, recovery is usually limited because an injured spine can’t heal due to the formation of scar tissue triggered by an inflammatory response that keeps healthy cells from reaching the damaged area. The spinal cord transmits information between the brain and the rest of the body. Injury to the spinal cord, which currently affects some , Europeans, can cause paralysis, and there is currently no effective treatment. Could stem cells help? What do we know? ▼.
The spinal cord transmits information between the brain and the rest of the body. Injury to the spinal cord, which currently affects some , Europeans, can cause paralysis, and there is currently no effective treatment. Could stem cells help? The spinal cord is a collection of millions of nerve cells neurons inside our spine that sends signals to and from the brain.
Damage to this important and delicate tissue is often permanent and can result in paralysis. However, several current clinical studies are testing the safety and effectiveness of stem cells as treatments.
These treatments hope to at least partially restore function to the spinal cord. Several studies have shown promising results, but definitive outcomes are still unknown.
Inflammation and toxins released by damaged cells at the site of a spinal injury often cause further harm to surrounding cells. Researchers are developing treatments that reduce inflammation and soak up toxins and free radicals to minimise additional damage. Damaging the supporting cells can cause otherwise functional neurons to die. Most stem cell treatments presently in clinical trials rely on transplanted stem cells to automatically repair damaged areas of the spinal cord.
Stem cell treatments for spinal cords are thought to work best if offered in the short time-frame after an injury. Scarring at the site of injury can hinder the effectiveness of a treatment, so this also needs to be addressed. The spinal cord is the delicate tissue encased in and protected by the hard vertebrae of the spinal column. The spinal cord is made up of millions of nerve cells that carry signals to and from the brain and into other parts of the body.
This information allows us to sit, run, go to the toilet and breathe. The main cell type found in the spinal cord, the neuron, conveys information up and down the spinal cord in the form of electrical signals. An axon also known as a nerve fibre is a long, slender projection of a neuron that conducts these signals away from the neuron's cell body. Each neuron has only one axon, and it can be as long as the entire spinal cord, up to 45cm in an adult human.
The axons that carry messages down the spinal cord from the brain are called motor axons. They control the muscles of internal organs such as heart, stomach, intestines and those of the legs and arms.
The axons that travel up the cord to the brain carry sensory information from the skin, joints and muscles touch, pain, temperature and from internal organs such as heart and lungs. These are the sensory axons. Neurons in the spinal cord also need the support of other cell types. For example, cells called oligodendrocytes increase the speed and efficiency of electrical signalling of axons by forming myelin - structures that wrap around and insulate the axon.
A spinal cord injury affects both neurons and the myelin sheath that insulates axons. Spinal cord injuries are devastating and debilitating conditions affecting people all over the world, particularly young adults. They are associated with severe physical, psychological, social and economic burdens on patients and their families. To develop effective treatments for spinal cord injuries, a precise understanding of the main events following the injury and how these events interact is needed.
Spinal cord injuries generally involve two broad chronological phases that are sustained by the primary and secondary mechanisms of injury. Primary injuries include shearing, laceration, and acute stretching. Acceleration—deceleration events can also cause spinal cord injury, but very rarely lead to complete disruption of the spinal cord.
At a cellular level, axons are crushed and torn, and oligodendrocytes, the cells that make up the insulating myelin sheath around axons, begin to die. Exposed axons begin to degenerate, which disrupts neuron connections and the flow of information along the spinal cord. The spine has different sections. The level of paralysis depends on the location of the injury. The body cannot replace cells destroyed by spinal cord injuries, which is why these injuries often lead to permanent movement and sensation impairments.
Many spinal injuries result in patients being paralyzed and without sensation from the level of the injury downwards. Injuries high in the neck, such as that suffered by Superman actor Christopher Reeve, paralyze the whole body including the arms and shoulders. A common level of injury is just below the ribs, resulting in normal arm function but paralyzed legs.
Depending on the location and the extent of the injury patients may suffer complete or incomplete paralysis, and loss of feeling, sexual function and bowel control. The severity of neurological injury, the level of the injury and the presence of a zone of partial cord preservation are accepted predictors of recovery and survival after spinal cord injuries.
The presence of spared axons crossing the injury site holds great therapeutic potential, and is the basis of a number of emerging therapeutic strategies. Despite the important advances in the understanding of spinal cord injuries, to date, almost all therapies that have shown promise at the preclinical stage of study have failed to translate into clinically effective treatments.
Medical care immediately after the injury — including immobilising and bracing to stabilise the spine - can help to minimise the damage to nerve cells. Rehabilitation can help patients regain physical and emotional independence.
A spinal cord injury is complex, involving different kinds of damage to different types of cells. The environment of the spinal cord changes drastically during the first few weeks after injury immune cells flow in, toxic substances are released, a scar is formed.
A combination of therapies is needed, acting at the appropriate time-point and on the correct targets. Studies in animals have shown that a transplantation of stem cells or stem-cell-derived cells may contribute to spinal cord repair by:. Different cell types, including stem cells, from a variety of sources, including brain tissue, the lining of the nasal cavity, tooth pulp, and embryonic stem cells, have been tested in these studies — mostly conducted in rat models of spinal cord injuries.
None of these cells have produced more than a partial recovery of function, but it is an active area of research, and several different types of stem cell are being tested and modified. Neural stem cells mouse. Allogeneic single donor neural stem cells are being investigated for their potential in treating spinal cord injuries. There are several clinical trials examining human neural stem cells in spinal cord injuries see clinicaltrials.
These trials inject neural stem cells directly into the spinal cord with the hope that the cells help re-establish some of the connections between neurons and create the necessary cells to support both the old and new neurons.
The trial used specific stem cells derived from human brain tissue neural stem cell or NSCs , which can make any of the three major kinds of neural cells found in the central nervous system. The trial was based on preclinical evidence that oligodendrocyte cells were replaced after transplanting human NSCs into in a particular mouse model for spinal cord injuries. This trial was officially completed in June clinicaltrials.
NCT and in another clinical trial was started to test the safety and efficacy of HuCNS-SC transplantation in cervical spinal cord injuries clinicaltrials. However, Stem Cell Inc. The outcomes appear to have been safe, but were not as effective as the company was aiming for. Stemcells Inc. The trial will include a total of 8 patients, four of whom have thoracic spinal cord injuries causing complete loss of sensory and motor function.
This trial is currently recruiting with an estimated completion of treatments in and study results in The Miami Project clinical researchers currently have several clinical trials and clinical studies available for people who have had a spinal cord injury; some are for acute injuries and some are for chronic injuries. The clinical trials are testing the safety and efficacy of different cellular, neuroprotective, reparative, or modulatory interventions.
The Miami Project is also sponsoring a Phase I clinical trial of autologous human Schwann cell ahSC transplantation in participants with chronic spinal cord injuries clinicaltrials. While the former trial was completed in , the latter is currently recruiting - approximately until January Clinical Trials clinicaltrials.
MSCs are injected in a number of different ways in these trials - including directly into the spinal cord or the lesion itself, intravenously, or even just in the skin. The hope is that when transplanted into the injured spinal cord, these cells provide tissue protective molecules and help to re-establish some of the circuitries important for the network of nerves indirectly from cell integration and differentiation. More information can be found here. California based biotech Geron had a widely reported clinical trial under way for a treatment — the first of its kind — involving the injection of cells derived from human embryonic stem cells.
The injected cells were precursors of oligodendrocytes, the cells that form the insulating myelin sheath around axons. Researchers hoped that these cells, once injected into the spinal cord, would mature and form a new coating on the nerve cells, restoring the ability of signals to cross the spinal cord injury site. After treating four patients with these cells in a Phase I clinical trial and reporting no serious adverse effects, Geron announced in November it was discontinuing its stem cell programme.
Following up on the cellular technology initially developed by Geron, Asterias Biotherapeutics has developed a program that focuses on treating spinal cord injuries with specially developed oligodendrocyte progenitor cells OPCs , precursors of oligodendrocytes. The hope is that when transplanted into the injured spinal cord abruptly after injury days , OPCs may re-myelinate and restore lost functions. In a Phase I clinical trial , five patients with neurologically complete, thoracic spinal cord injury were administered embryonic stem cell-derived OPCs at the site of injury.
Delivery of OPCs was successful in all five subjects and no serious adverse events were associated with either the administered cells or the accompanying immunosuppression regimen. In four of the five subjects, MRI scans suggested a reduction in the volume of spinal cord injury.
Outside of the approved clinical trials process, some companies offer stem cell related treatments for patients with spinal cord injuries, without significant evidence that the treatments they offer have been successful. Anyone considering paying for such a treatment is encouraged to discuss it with their physician, and to read this information document prepared by a group of spinal cord injury doctors:. Experimental Treatments for Spinal Cord Injuries: What you should know if you are considering participation in a clinical trial.
Although, stem cells are very useful in spinal cord injury research and are beginning to be tested in clinical trials, there are currently no proven and approved stem cell treatments available for spinal cord injuries.
Several different approaches and types of stem cells are being investigated for their potential use in future treatments. Depending on the type of stem cell and the way it is implanted, the aim of the various strategies is to bridge the injury so that axons can regenerate, to replace lost myelin, and to protect the cord from spreading damage after the injury.
It is likely that we will see further clinical trials based on these strategies. Ready or not? A role play on taking stem cells into the clinic the scenario is around a clinical trial for spinal cord injuries. National Institute of Neurological Disorders and Stroke: detailed information on spinal cord injury.
Christopher and Dana Reeve Foundation: includes lots of video content and other useful resources. Spinal Research: UK charity funding medical research to develop treatments for paralysis. News article in the Guardian on embryonic stem cell clinical trial. Spinal cord injuries: how could stem cells help?
Factsheets Spinal Cord Injuries. What do we know?
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