‘Spinal tap’ saving crash victims from life in a wheelchair: Breakthrough nerve-preserving procedure could spare people from paralysis

Spinal injury victims could be spared from paralysis thanks to a breakthrough nerve- preserving procedure developed by British doctors. It is the first treatment to tackle inflammation of the spinal cord, which can occur in the hours and days after an accident, causing irreversible damage.

Given in these crucial hours, the ‘spinal tap’ procedure works by reducing the pressure build-up within the spinal column caused by swelling and so preserves vital nerve function.

The doctors who developed the new treatment say they are seeing ‘incredible’ results that are ‘far beyond what we would have expected’.

One of the first 17 patients to have been saved from life in a wheelchair is Steven Dowd, 37, who was involved in a cycling accident in June. He hit his head and suffered what his doctor described as a ‘severe’ spinal injury at the base of his neck.

Steven, who lives in Woolwich, South-East London, with his wife Helen, 50, said: ‘I was a head on a pillow. I’d lost all sensation from the neck down. Only my heart, lungs, eyes and voice worked. I thought I would be a tetraplegic for the rest of my life.’

Astonishingly, today he is walking again with the help of one crutch, and credits his doctors’ swift intervention for saving his life.

His surgeon, Professor Marios Papadopoulos at the Department of Neurosurgery at St George’s Hospital in South-West London, said: ‘Steven’s injury was at the severe end of the spectrum.

‘He had no feeling in his body but there was a small amount of reflex movement when we tested him.

‘We don’t know how well he would have recovered if we’d not given him this new treatment, but the result is incredible and far beyond what we would have expected.’

About 1,200 people are paralysed after such an injury each year in the UK, and it is thought some 40,000 people are living with paralysis as a result of an accident.

The spine is made up of bony vertebrae and discs, encasing and protecting the spinal cord, a tube of nerves and supporting tissue that controls sensation and movement in the body. The cord itself is surrounding by fluids and encased in a tough membrane known as the dura.

In the event of a spinal injury, there is some immediate damage to the bones and nerves, but the full extent of a subsequent paralysis is determined by secondary events, including swelling of the spinal cord, release of chemicals at the site of the injury, and loss of oxygen. All contribute to destruction of the nerves.

 Injured Spinal Cord Pressure Evaluation procedure (ISCoPE)
Spinal injury victims could be spared from paralysis thanks to a breakthrough nerve- preserving procedure developed by British doctors

When the spinal cord swells after trauma, it presses against the dura and this cuts off the blood supply at the site of the injury, killing the nerve cells over time.

Medical treatment has focused on mending damaged bone and stabilising the spine. But saving as few as ten per cent of the nerve cells post-accident can make the difference between the ability to walk and a life in a wheelchair.

The Injured Spinal Cord Pressure Evaluation procedure (ISCoPE), developed by neuroscientists at St George’s, University of London, is carried out as an emergency procedure during the repair of the damaged vertebrae.

First, two fine ‘spinal tap’ probes are inserted into the site of the injury. One monitors the pressure of fluid in the spinal cord. The other allows a tiny amount of fluid to be pumped out of the spine where it is analysed for chemicals that indicate whether nerve cells are dying.

If the pressure in the cord is too high, drugs can be taken to allow more blood to flow into the injury site, helping keep nerve cells alive.

During a five-hour operation to fix Steven’s spine, Prof Papadopoulos implemented the ISCoPE procedure to save his nerve cells.

Over the next two months, Steven, who is head of recruitment at a bank, regained sensation first in his shoulders, then in his feet, knees, arms and hands.

By August, he could stand up and he had regained some use of his hands. He had also taken his first steps.

‘Now I can make myself a cup of coffee. I can use my iPad and I can put my T-shirt, shorts and shoes on,’ said Steven, who is still in hospital at Royal National Orthopaedic Hospital in Stanmore, Middlesex.

‘Until two weeks ago I was using a frame to walk, but then a week ago I went on to two crutches. Now I’m walking with one crutch.

‘My goal was to be completely back to normal within 200 days of the accident, which will take us up to Christmas!’

Dr Samira Saadoun, a senior lecturer in Neuroscience at University of London, who developed the treatment with Prof Papadopoulos, said: ‘Spinal-cord injury is usually caused by an accident and the prognosis is usually very poor.

‘Traditionally, surgeons have used screws and rods to fix the broken bone in the spine, but until now no one has known what has been happening to the damaged cord inside.

‘Saving these neurons at an early stage could mean the difference between being able to use your hands again or not. It could decide whether patients are able to control their bowels or not, for example.’

Prof Papadopoulos and Dr Saadoun hope to see the treatment available in UK hospitals within the next three years.

By Christine Fieldhouse For The Mail On Sunday

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