Spinal Cord Injury
Spinal cord injury is the damage to any part of the spinal cord or nerves attached to it in the spinal canal. Usually the injury causes permanent loss of strength, sensation and other body functions below the site of the injury.
Since this injury has debilitating effect on the life of affected persons, many scientists are working globally to bring optimum treatment protocol so that there is substantial improvement in the quality of life of these patients. Research studies are ongoing around the world. In this pursuit Stem cell therapy Spinal Cord Injury / Autologous bone marrow derived stem cell transplantation has come up as a game changer and helping a lot of patients in enhancing their recovery. In the meantime, treatments and rehabilitation allow many people with spinal cord injuries to lead productive & independent lives.
Types of Spinal Cord Injury
There are four sections of the spinal cord
. Cervical cord
The neck region above the shoulders is injured in cervical spinal cord injury and it results into loss of muscle power, sensation and loss of control over bladder and bowel in the region below neck.
Injury occurs between base of neck and loin area ( junction of lower and middle part of spine). It leads to loss of muscle power, sensation and loss of control over bladder and bowel in the region below the level of injury.
Lumbar & sacral cord
It is lower part of spine so usually outcome is better. But injuries in the sacral region are usually partial and fast to recover while lumbar injuries cause paraplegia or complete loss of muscle power, sensation and loss of control over bladder and bowel in the region below the level of injury. So each section of the spine protects different groups of nerves that control different parts of the body and perform different functions, depending upon the section of the spine involved.
Outcome of patients in spinal cord injury
Usually outcome of patients depend upon the level of injury and its severity. As a whole the outcome in cervical and thoracic cord injury is poorer than lumbar and sacral cord injury. Severity of injury is internationally assessed by ASIA ( American spinal injury association) score.
ASIA Impairment Scale (AIS)
A = Complete. No sensory or motor function is preserved in the sacral segments S4-5.
B = Sensory Incomplete. Sensory but not motor function is preserved below the neurological level and includes the sacral segments S4-5 (light touch or pin prick at S4-5 or deep anal pressure) AND no motor function is preserved more than three levels below the motor level on either side of the body.
C = Motor Incomplete. Motor function is preserved at the most caudal sacral segments for voluntary anal contraction (VAC) OR the patient meets the criteria for sensory incomplete status (sensory function preserved at the most caudal sacral segments (S4-S5) by LT, PP or DAP), and has some sparing of motor function more than three levels below the ipsilateral motor level on either side of the body. (This includes key or non-key muscle functions to determine motor incomplete status.) For AIS C – less than half of key muscle functions below the single NLI have a muscle grade ≥ 3.
D = Motor Incomplete. Motor incomplete status as defined above, with at least half (half or more) of key muscle functions below the single NLI having a muscle grade ≥ 3.
E = Normal. If sensation and motor function as tested with the ISNCSCI are graded as normal in all segments, and the patient had prior deficits, then the AIS grade is E. Someone without an initial SCI does not receive an AIS grade. Using ND: To document the sensory, motor and NLI levels, the ASIA Impairment Scale grade, and/or the zone of partial preservation (ZPP) when they are unable to be determined based on the examination results.
Complete Spinal Cord Injury versus Incomplete Spinal Cord Injury
Spinal cord injuries can be divided into two types of injury – complete and incomplete:
• A complete spinal cord injury causes permanent damage to the area of the spinal cord that is affected. Paraplegia or tetraplegia are results of complete spinal cord injuries. • An incomplete spinal cord injury refers to partial damage to the spinal cord. The ability to move and the amount of feeling depends on the area of the spine injured and the severity of the injury. Outcomes are based on a patient’s health and medical history.
1 surgical management –usually in the form of decompression and stabilization of spine
2 Rehabilitation protocol—currently it is very important part of treatment
3 Newer options of treatment
Stem cell therapy in Spinal Cord Injury —It is done as Autologous bone marrow derived stem cell transplant. It is safe and reasonably effective in enhancing the speed of recovery in these patients. It can be repeated at certain intervals depending upon condition of patient.
Some growth factors like BDNF or brain derived nerve growth factors have also shown some positive effect.
Nutraceuticals as adjuvant therapies
Lyprinol or omega 3 fatty acids help in decreasing inflammation and improving nerve regeneration.
Combinations of Ubiquinol and omega 3 fatty acids ( Quranerv-M) also help in improved neuronal formation.
Stem cell nutrients like Nutristem, help in faster recovery.
Some testimonials of patients of spinal cord injury ,are here who improved after stem cell therapy