From the lab to the operating room

Published: May 17, 2007  |  Source: canada.com
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797-226Dr. Brian Kwon just may be the future of spinal cord research.

The 35-year-old medical specialist splits his professional time these days performing delicate surgeries on patients with spinal cord injuries at Vancouver General Hospital, and doing lab work at the University of B.C. where he recently attained his PhD in the field of neural regeneration.

There aren’t many people in Canada right now, maybe two or three others, who can do what Kwon and his research team does — that is, bring tangible experience and discoveries from the lab straight into the surgery room, and vice versa.

It offers him a unique perspective on spinal cord treatment, one that could lead to the kind of life altering medical breakthrough for which wheelchair activist and athlete Rick Hansen has been lobbying for more than two decades. According to spine surgeon Dr. Marcel Dvorak, Kwon “is the guy who is going to come up with the cure. He’s going to come running in one day and say, ‘Look, you should try this. I really think this is going to make the difference,'” Dvorak said.

To date, no cure exists for someone with a complete spinal cord injury. That means once paralysed, spinal cord patients lose function in their legs — and other limbs depending on the injury — for good.

Much of the work, to date — in large part inspired by Hansen’s historic Man in Motion tour 20 years ago — has been in understanding how to repair a damaged spinal column, the bone structure that protects the soft, neurological structure of spinal cord.

According to Dvorak, there have been “huge” medical advancements in recent years allowing doctors to safely operate on spinal cord patients, removing bone from and taking pressure off the spinal cord.

But it’s only now that work on repairing a damaged spinal cord has begun, with researchers like Kwon currently studying methods to squeeze every last drop of recovery from an injured spinal cord.

Kwon’s focus is to regenerate damaged nerves to allow for incremental changes in a patient’s function. Even a few millimeters of growth could mean a world of difference for patients whose injuries have robbed them even of the most basic of life functions — like breathing without a respirator or moving a hand, or even a finger.

Worldwide, advancements in spinal care treatment over the past 20 years — from surgical techniques, to improvements in anesthesia and Rehabilitation practices — have enabled more and more patients to walk away from spinal cord injuries that might have otherwise left them disabled.

For example, doctors point to the recovery of former B.C. premier Mike Harcourt, who suffered a severe spinal cord injury after an accident in 2002.

“He wouldn’t be walking away if he was injured 20 or 30 years ago,” said Dvorak.

Hansen said he’s continually inspired by all the work being done, much of it in Vancouver, to advance his dream of finding a cure, and he says he believes one will be found in the next two decades.

Right now, though, a cure is not the goal post.

“The goals right now are to try and get people incrementally a bit better function,” said Kwon.

“Certainly, down the road, our hope, and Rick’s dream, is to return people to full physical function. This is very much a longer-term goal.”

Still, there is much reason for hope, and a world of inspiration to be found in the spinal care patients themselves.

“It’s easy to get charged up about the research when you get constantly reminded on how devastating that injury is for people,” Kwon said.

dahansen@png.canwest.com

SPINAL CORD INJURY FACTS

– Spinal cord injury affects over 41,000 Canadians. 1,100 new injuries occur each year.

– 84 per cent of injuries occur to people under the age of 34.

– Most common causes of spinal cord injury in Canada are: Motor vehicles collisions (55 per cent), other medical conditions and sports injuries (27 per cent), and falls (18 per cent).

– The unemployment rate for people with SCI is 62 per cent.

– The cost to the Canadian health system is between $1.25 million and $25 million during the lifetime of each injured person, depending on the severity of the injury. Annual health-care costs for those with spinal cord injury are $750 million.

– 90 per cent of what we know about spinal cord injury has been discovered in the last 20 years. (Source: Rick Hansen Foundation)

Darah Hansen, Vancouver Sun
© The Vancouver Sun 2007