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Study could boost spinal treatments

| Source: sltrib.com

20091212__spinalcord_1214~3_GALLERYResearch to begin sooner, track patients for two years.

Like looking at an iceberg, Brandon Sulser’s immobility is only the tip of his challenges from quadriplegia. “Being in the wheelchair, that’s the easiest part,” he says.

Sulser’s severely bruised spinal cord makes it difficult to breathe, because his diaphragm is weaker. It’s easy to overheat because his body doesn’t sweat. Quadriplegics and paraplegics often have lowered heart rates, leaving them prone to dizziness and fainting, struggling to keep up with workouts and at a higher risk for heart attacks.

Usually, doctors and physicians study and treat those complications when a patient is undergoing rehabilitation. But now Intermountain Medical Center, teaming with the James J. Peters VA Medical Center in New York City, will research those effects right after a spinal cord injury occurs.

The effects of spinal cord injuries are widespread because nerves are linked to the whole body — “It’s how the brain talks to everything in your body,” said Jolene Fox, a senior researcher at the Intermountain’s trauma services.

The observational study’s goal is to pinpoint the timing and way different systems deteriorate. Future studies could develop treatments to address those changes before rehab, and help improve a patient’s quality of life.

“Right now, it’s more that we support body systems until they get to rehab,” said Mark Stevens, trauma services medical director at the Murray hospital. “What we hope is that these studies would lead to interventions to treat those changes.”

Patients with severely bruised or severed spinal cords are often kept in the trauma area for 10 to 20 days before they are released to begin rehabilitation, Stevens said.

But now, Stevens hopes to enlist patients who will allow their various organ systems to be tested within three days of their injury. He expects to find that dramatic changes occur quickly.

The days after the injury can be a difficult for people adjusting to the likelihood they will be paralyzed, but Sulser, who now works at Intermountain counseling other patients, expects many will enroll.

“I think a majority of people, if not all, would love to be part of this research because it gives us more of a future and a better hope of recovery,” Sulser said.

Patients will be followed for two years, with their blood drawn, muscles biopsied, and hormone levels and composition of fat and muscle tested. The hospital will recruit participants for two and a half years.

Intermountain partnered with the James J. Peters hospital, which has already done intensive research into how organ systems are affected by spinal cord injury. But the New York hospital’s research has been limited to the rehabilitation patients it receives, Fox said.

Intermountain’s study will add findings about the initial effects of spinal cord injuries, she said.

Sulser thinks the research will yield information that improves the quality of life of spinal cord injury patients with recent injuries and those who have been affected for years. His injury, which occurred 11 years ago, left him paralyzed from the neck down with a limited ability to use his arms.

Even little improvements to patients’ health “[change] dramatically what we’re able to achieve and our quality of life,” Sulser said. “And it gives us better hope.”

How the study works

Starting today, patients who arrive at Intermountain Medical Center with severely bruised or severed spinal cords will be asked within 72 hours to join a new study of how such injuries immediately impact the body. After tests that range from muscle biopsies to measurements of hormone levels, patients will receive further testing for up to two years.

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