Transplant of nasal cavity cells to spinal cord enables this paralysed man to walk once again
Paralysis is perhaps the most debilitating medical conditions in which the patient is capable of hearing and understanding everything, but cannot move or walk. The frustration of not being able to do things on your own and having to depend on others for most basic work is something paralytic patients have to go through.
But the science of medicine has made such advancements that now it has become possible for paralytic patients to get up on their own will and walk and sit again. One such advancement was successful when a quadriplegic patient from Poland walked again due to a revolutionary surgery.
Here is the incredible story.
1 Darek Fidyka
Darek Fidyka, 40, from Poland, was paralyzed after being stabbed repeatedly in the back in the 2010 attack.
But now thanks to a revolutionary breakthrough in medicine, he is able to walk with a support of a frame. He said that “When you can’t feel almost half your body, you are helpless, but when it starts coming back it’s like you were born again.” He further added that,” what had been achieved was more impressive than man walking on the moon”.
2 How the injury was treated
Before the treatment, Mr Fidyka had been paralysed for nearly two years and had shown no sign of recovery despite many months of intensive physiotherapy.
The treatment used olfactory ensheathing cells (OECs) – dedicated cells that form part of the sense of smell. OECs act as pathway cells that allow nerve fibres in the olfactory system to be frequently reintroduced.
In the first of two operations, surgeons detached one of the patient’s olfactory bulbs and grew the cells in culture. Two weeks later they transferred the OECs into the spinal cord, which had been cut through in the knife attack apart from a thin sliver of scar tissue on the right. They had just a drop of material to work with – about 500,000 cells.
About 100 micro-injections of OECs were given above and below the injury. Also four thin strips of nerve tissue were taken from the patient’s ankle and placed across an 8mm (0.3in) gap on the left side of the cord. The scientists believe the OECs created a pathway to permit fibres above and below the injury to rejoin, using the nerve implants to link the gap in the cord.
3 The breakthrough
The groundbreaking research was supported by the Nicholls Spinal Injury Foundation (NSIF) and the UK Stem Cell Foundation (UKSCF).
A main alteration with Mr Fidyka was that the scientists were able use the patient’s olfactory bulb, which is the lushest source of olfactory ensheathing cells. Meaning that there was no risk of rejection, and so no need for immunosuppressive drugs used in orthodox transplants.
Majority of the repair work of Mr Fidyka’s spinal cord was completed on the left side, as there was an 8mm gap. He has since recovered muscle mass and movement mostly on the left side. Scientists believe this is evidence that the recovery is due to restoration, as signals from the brain supervisory muscles in the left leg travel down the left side of the spinal cord.
MRI scans also propose that the gap in the cord has sealed up following the treatment. None of those involved in the research need to profit from it. Prof Geoff Raisman said: “It would be my proudest boast if I could say that no patient had had to pay one penny for any of the information we have found.”
NSIF said if there were any patents arising; it would acquire them so as to make the technique freely available.
4 The sense of smell and spinal repair
The intricate neural circuitry responsible for our sense of smell is the only part of the nervous system that revives throughout adult life. It is this ability that scientists have tried to exploit in encouraging repair in the spinal cord.
Each and every time we breathe molecules carrying different odors in the air come into contact with nerve cells in the nose. These convey messages to our olfactory bulbs – at the very top of the nasal cavity, sitting at the base of the brain.
The nerve cells are being repeatedly injured and must be substituted. This procedure of regeneration is made likely by olfactory ensheathing cells (OECs), which provide a pathway for the fibres to grow back.
5 The researchers
All those taking part in the research are trying their best not to raise false hopes in patients and stress that the accomplishment will need to be repetitive to show conclusively whether it can stimulate spinal cord regeneration.
The scientist involved in the process, Prof Raisman has an experience of 40 years learning how to repair the spinal cord. In 2005, Prof Raisman was approached by a Polish neurosurgeon that had begun researching how to apply the technique in humans.
Dr Tabakow carried out an initial trial involving three paralyzed patients who each had a small amount of OECs injected in their damaged spinal cords. Dr Tabakow said: “Our team in Poland would be prepared to consider patients from anywhere in the world who are suitable for this therapy. They are likely to have had a knife wound injury where the spinal cord has been cleanly severed.”