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‘The Movement’ Toward Spinal Cord Injury Repair

| Source: everydayhealth.com

kelly-brush-skiing-articleEach year, more than 12,000 people — usually young adults — experience a serious spinal cord injury. But it is possible to rise above paralysis.

Competing as an NCAA ski racer down a fast slope in Massachusetts, Kelly Brush hit an icy patch, catapulted off the trail, and hit a lift tower stanchion that fractured her spine, four ribs, and a vertebra in her neck. She also had a collapsed lung. After 10 hours of surgery, Brush found herself alive, but paralyzed from the chest down in Feb. 2006.

“[Skiing] was such a big part of my life beforehand, and I loved it so much that I was never mad at the sport of skiing or scared by it,” the now 26-year-old says. “It was actually really funny because [my accident ] was during the Olympics, and I remember lying in my hospital bed and waking up in the middle of the night and turning the Olympics on, watching ski racing and not thinking anything weird of it.”

She spent two and a half months at a rehab facility in Colorado, where she relearned everything — from dressing herself to driving — and discovered that she could still be an athlete. During her stint at rehab, she learned how to use a handbike, an adaptive golf cart, and even adaptive scuba diving gear.

Monoskiing – skiing with an adaptive device specifically designed for people with disabilities — was next.

“The biggest thing for me when I was in rehab was learning that I could do sports still and learning that I could still be active,” she says. “It opened up my whole world, so I could see what my life could potentially be like still.”

For Rick Finkelstein, a Universal Pictures executive, the draw back to the slopes was similar.

“You can’t get that sensation anywhere else,” Finkelstein says as he monoskis in the documentary The Movement. “It’s just that freedom and movement, balance and weight control — it’s just the best. Just the best.”

Finkelstein, too, was paralyzed in a skiing accident, but in 2004. His return to the slopes is chronicled in the film, narrated by Robert Redford.

The film captures Finkelstein’s frustration, fear, and ultimately, his joy over returning to the sport he loves that also smacked him down in one quick moment and left him paralyzed. Although spinal cord injuries from sportsare declining, according to the National Spinal Cord Injury Statistics Center in Birmingham, Ala., about 900 sports-related spinal cord injuries occur every year. Fortunately, research is aimed at reversing the damage.

The Latest Advancements in Spinal Cord Injury Treatment

Today, most research focuses on new healing techniques for recently injured patients.

Most experts in the field agree that significant help for spinal cord injury will come through a combination of cell transplantation and repair and biomaterial scaffolds that can help rebuild the spinal cord from the inside out, says spinal cord researcher Kim Anderson, PhD. Anderson is the director of education at the Miami Project to Cure Paralysis and a researcher in the department of neurological surgery at the University of Miami Miller School of Medicine. She has also lived with a spinal cord injury since age 17, when she was involved in a car accident.

“I think that, actually, we have made a lot of discoveries over the past 15 years in our understanding of what happens inside the spinal cord,” she says.

Today, her research is focused on developing new ways to validate outcomes in clinical trials using issues that are important to people with spinal cord injury. “When I first started working on this in 2004, a lot of the animal research models were only looking at walking,” she says, “but my research found that walking wasn’t the most important thing to people with spinal cord injury. Arm and hand function, sensation, getting rid of pain, sexual function with spinal cord injury — surveys indicate these issues were more important to patients.”

As researchers work to identify new ways to improve outcomes in spinal cord injury cases, Anderson says these areas are key to progress:

  • Neuroprotection. This research areas aims to protect the spinal cord against additional damage immediately after injury, either through cell transplants or pharmacological therapies. “There are several different avenues people are exploring,” Anderson says. “Either a few hours or a few days after an injury occurs, these interventions interrupt the processes happening inside the spinal cord to keep more of the healthy spinal cord intact and to have more function.”
  • Functional therapy. Functional therapy looks at what people with spinal cord injuries can do physically, improving their quality of life. Some techniques include electrical stimulation to improve limited movement, and locomotion therapy, which helps patients use damaged muscles.
  • Biomaterials. Biomaterials, which are engineered materials that biodegrade over time, help stimulate new cell growth and re-establish nerve connections. Researchers believe biomaterial scaffolds, when combined with cell therapy, are the best bet for promoting spinal cord repair. “Biomaterials help the new cells delivered to the injury site stay there,” Anderson says. “While the new cells are doing their work, the biomaterial will slowly dissolve away, in the process providing some sort of material for new tissue to grow on.”
  • Cell replacement and regeneration. A spinal cord injury typically results in a fluid-filled cyst in the spinal cord, Anderson explains. Cell replacement aims to fill this cyst with healthy cells when used in conjunction with a biomaterial while regeneration attempts to reactive nerve cells and encourage growth. Some of the most promising research in the field is in these areas: This summer, the U.S. Food and Drug Administration approved a first-of-its-kind phase 1 clinical trial to evaluate the safety of transplanting human Schwann cells (the cells that cover the nerve fibers of the peripheral nervous system and help transport nerve impulses) into patients with paralysis.

However, the small, heterogeneous population of people with spinal cord injury make clinical applications for this research difficult, as it’s difficult to find a critical mass of alike patients for clinical trials, Anderson says.

“Because so many cases are so different, the field believes is that to get the most amount of repair and function in patients, we need a combination of effective therapies,” Anderson explains. The goal is to have a “cocktail of safe and effective treatments” for doctors to use and apply to each individual patient, she says.

A New Passion

Amazingly, not only was Brush using a monoski the very next season, but she has also gone on to dedicate her life to promoting ski safety and helping other people with spinal cord injury. Through the Kelly Brush Foundation, she has launched a national awareness campaign ski racing safety and has raised more than a million dollars for ski racing safety gear and adaptive sports equipment for people with spinal cord injury. To date, the foundation has given away more than 40 pieces of adaptive sports equipment for individuals.

“I want to make sure that people can get this equipment, so they don’t have to have no activity in their life,” she says. “I can’t imagine what that would be like for me.”

She says she’s completely at peace with her injury, but wants to continue her work to help other, newly injured patients gain functionality.

“What really needs to happen is more trials and more studies done for people who are newly injured,” she says. “From there, maybe they can sort of tackle the people who have been injured for a long time.”

Photo courtesy of Kelly Brush.
By Annie Hauser, Everyday Health Staff Writer

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