The Spinal Cord and Spinal Cord Injury

(THIS WAS AN INFORMATIVE SPEECH I DID FOR MY COM220 CLASS ON THE STAGES OF SPINAL CORD INJURY RESEARCH. IT ACTED AS AN INTRODUCTION TO MY PERSUASIVE SPEECH ON THE BENEFITS OF STEM CELL RESEARCH)

Before we determine how stem cells can treat various diseases including spinal cord injuries, let us first

There are many different types of stem-cells which can be implanted in patients to regenerate or replace the damaged or abnormal cells caused by not only diseases like Parkinson's but also Alzheimer's and spinal cord injuries (2). A specific example in relation to Parkinson's is the harvesting of embryonic stem cells. These human embryonic stem cells can be transplanted into the brain to replace and create dopamine neurons. The controversy is in how one can obtain these stem cells. During fertilization, in humans, the embryo is hollow and contains cells that eventually develop into a fetus (1). Researchers have discovered, as recently as 1998, that the cells in the embryo contain all

King will be talking about how dangerous football is. There will be knee cartilagae tears. I will also be talking about spine injuries. The final thing is death. Thatnis all.

In humans adult stem cells, not embryonic stem cells, have been used in therapies for more than forty years. People with blood disorders have used stem cell therapy to take the opportunity to improve upon their life. On the other hand, embryonic stem cells have a very high potential to treat or even cure numerous diseases like diabetes and heart disease. They are much more versatile in their usage compared to adult stem cells. Another practical use for embryonic stem cells is to treat damaged nerves ("Testing The Use…”). These nerves could have been impaired in a spinal cord injury. As of today, scientists have already performed stem cell transplants in people whose cells were damaged through chemotherapy of disease.

The central nervous system is what connects the brain to the muscles of the body. When a patient has an injury to the spinal cord, movements in certain parts of the body will be affected based on the location of the injury. If the injury affects hand motion then many day to day tasks are affected. This literature review seeks to understand how an injury to the spinal cord impacts movement, and what has been done so far to help those affected by spinal cord injuries.

Spinal cord injuries can be extremely debilitating with significant impairment in autonomic, sensory, and motor function (Coll-Miro et al., 2016). The prevalence in Canada is on the rise with approximately 86,000 individuals suffering from such injuries as of 2010 (Noonan et al., 2012). Spinal cord injuries are generally classified as either traumatic or non-traumatic, depending on etiology (Sabapathy et al., 2015). In addition, they are subdivided into either complete or incomplete, depending on whether the spinal cord section is fully or partially damaged (Wilberger and Dupre, 2015). The latter classification has better clinical outcomes as some neurologic function is reserved (Wilberger and Dupre, 2015). Other subtypes include paraplegia and quadriplegia denoting paralysis of the lower body or all limbs, respectively (Wilberger and Dupre, 2015; Mayo Clinic Staff, 2014). The pathogenesis of spinal cord injuries is characterized by primary tissue damage due to the force of impact, followed by secondary tissue damage as a result of the inflammatory response (Sabapathy et al., 2015; Coll-Miro et al., 2015). The symptoms and severity may vary depending on the location and pathology of the contusion (Sabapathy et al., 2015). Presenting symptoms include but are not limited to numbness or pain in the extremities, loss of sensation, impaired movement or gait, abnormal reflexes, disrupted bladder or bowel function, and sexual dysfunction (Mayo Clinic Staff, 2014). Several

A simple car accident can result in a simple broken spine and a life with quadriplegia, a horrifying warning on the permanences of damage on the central nervous system. It is an unhealable injury, one which accompanies the victim for a lifetime. While thousands of years of medicine demonstrate the neuron’s regeneration incapability, studies have shown that spinal cord nerves have an innate regeneration ability. When reattached, they can restore themselves and allow the patient to regain movement. But healing the gray matter of the brain remained elusive until additional studies demonstrated that outside of the human body, the neurons can flourish. There was something other than the neurons that inhibited its growth and regeneration. This factor was later discovered to be a protein in the myelin and a product of the Nogo gene.

Spinal cord trauma affects a multitude of individuals globally. Many common spinal cord injuries occur frequently from motor vehicle accidents, athletics, falls, and disease and are not curable (Center NSCISC 2013). Depending on the area that is damaged, there are numerous consequences of spinal cord injuries that affect the body in different ways. As individuals age, their susceptibility to such injuries significantly increases and is frequently caused by falling. However, anyone is susceptible to spinal cord trauma. In the United States, 906 individuals per one million have some sort of spinal cord injury. The peak age of those affected is younger than thirty and the elderly. The most prevalent reason comes from automobile accidents and

Some of these strategies are promising and capable of restoring some motor function in spinal muscular atrophy models, especially increasing SMN protein production via upregulation of the SMN2 gene. However, this is a more global approach and these drugs have been shown to cause toxic side effects in other cells. Another more specific approach involves antisense oligonucleotide (AON) technology to modulate mRNA splicing in order to create additional functional SMN protein from the SMN2 gene as compared to the typical 10-30%. This has been shown to be effective in mice but the issue is the need for an efficient delivery system in humans. Another promising treatment strategy reprograms fibroblasts into induced pluripotent stem cells to compensate for the damaged motor neurons. This has been promising in the mouse model and may translate better to human motor neurons than other tactics. Some difficulties in developing effective treatments include unwanted toxic side effects and manipulating pharmacokinetics to allow for effective treatment. Scientists are working to develop a better understanding of the genetic mechanism of the disease and develop more efficient strategies of delivering drugs4. In addition,

Brain and spinal injuries are very serious conditions due to the ability to change or stop certain body functions permanently. One can be born with brain damage in which case the brain cells have been killed off. Spinal damage on the other hand can occur at any point in a lifetime. There are many different consequences to getting these injuries such as muscle failure.

Approximately 11,000 new cases of spinal cord injury (SCI) occur in the United States each year, contributing to the over 200,000 individuals currently living with SCI. SCI results in tremendous changes in an individual’s life, causing impairments to the musculoskeletal, cardiopulmonary, integumentary, gastrointestinal, genitourinary and sensory systems. Mobility and self-care become limited as well as participation in social and everyday activities when SCI causes paralysis of the muscles below the injury1. An individual who was once independent may now have to depend on others for help in their daily routine. The rehabilitation process plays a major role in helping those with SCI become as independent as possible, and physical therapists

Spinal cord injury (SCI) can be dated back to the Egyptains, “who described it as an ailment not to be treated” (Sarhan, Saif, & Saif, 2012 p .319). SCI victims had no hope for a normalized future and were confined to wheelchairs and experienced poor survival rates because of the demands of care. Advancements in emergency care and rehabilitation practices increase neurological function to the spine which has increased the SCI victim’s changes of survival and return to normal locomotion. The spinal column can be divided into “31 segments” and “comprise seven cervical, twelve thoracic, five lumbar and five sacral vertebral segments” which protect the spinal cord (Sarhan, et al. p. 319 & 320). The nerves of the spinal column relay biological information to and from the brain by ascending and descending tracts. A SCI occurs when acute trauma is generated to the spinal cord. Significant pathology and pathophysiology damage blocks communication between the brain and the rest of the body. A person’s motor skills, autonomic functions, and sensations are affected by the initial injury. The higher the injury occurs on the spinal column, the more dysfunctional the person may become. “The primary injury determines a given patient’s neurologic grade on admission and thereby is the strongest prognostic indicator” (Dumont, Okonkwo, Verma, Hurlbert, Boulos, Ellegala, & Dumont, 2001 p. 254). Secondary injuries can occur from vascular, cellular, and/or biochemical changes at the injury site.

These complications can cause nerve paralysis, which is treated by the removal of fragments of substance form the surgical procedure. To get the nerve to regenerate from the damage suffered during surgery doctors can place oxidized regenerated cellulose around the nerve (Ikeda). There is a need to find other ways to increase the regeneration capabilities of the sciatic nerves.

The following is a case study to assess the lived experiences of persons with spinal injuries in both the early post-acute and the long-term context using the International Classification of Functioning (ICF) as a frame of reference and using a focus group. Acute onset was defined as a sudden traumatic or non- traumatic incident resulting in spinal cord dysfunction within 14 days of onset. The long term context trails the early post-acute context. The post-acute context will define the rehabilitation phase after the acute onset.