Advances in Spinal Cord Injury Treatment: From Supportive Care to Stem Cell Therapy

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• Current Treatment Approaches
• Role of Steroids in Spinal Cord Injury
• Stem Cell Therapy Potential
• Tissue Engineering and Scaffolds
• Clinical Trials and Future Outlook
• Avoiding Unproven Treatments
• Full Transcript

Current Treatment Approaches for Spinal Cord Injury

Spinal cord injury treatment traditionally focuses on immediate supportive care. Dr. Eric Woodard, MD, explains that the primary goals are stabilizing the patient's medical condition. This includes supporting adequate blood pressure and other critical physiologic functions. Surgeons also work to remove any compressive lesions from the spinal cord. These can be fractured bone fragments or severely herniated discs.

Decompressing the spinal cord creates the best possible environment for healing. The initial injury is often just a fraction of the total damage. The body's subsequent inflammatory response can cause significantly more harm. This concept is central to modern treatment strategies for spinal cord trauma.

Role of Steroids in Spinal Cord Injury

High-dose steroids were once a mainstay of acute spinal cord injury treatment. Dr. Eric Woodard, MD, describes how steroids aimed to reduce secondary inflammation. This inflammation, or "secondary injury," can damage an additional 40% of the cord beyond the initial trauma. The theory was that quenching this inflammation could save more viable neural tissue.

However, extensive clinical trials showed that steroids offer only minimal benefit. Dr. Eric Woodard, MD, notes that prolonged steroid use actually leads to more complications. For this reason, the use of high-dose steroids for spinal cord injury has dramatically declined in the United States. The search for effective anti-inflammatory treatments continues.

Stem Cell Therapy Potential for Spinal Cord Repair

Stem cell therapy represents a revolutionary frontier in spinal cord injury treatment. Dr. Eric Woodard, MD, describes stem cells as specialized cells capable of becoming any tissue type. This includes brain tissue and neural tissue. The hope is that stem cells can help regrow the injured spinal cord and reverse damage.

Early research involved injecting stem cells directly into the acute injury site. Dr. Eric Woodard, MD, explains that this approach often failed. The toxic inflammatory environment present immediately after injury kills the injected stem cells. Research has since shifted to sub-acute and chronic phase injections, which show more promise for spinal cord regeneration.

Tissue Engineering and Scaffolds for Spinal Cord Support

The most promising advances combine stem cells with tissue engineering technology. Dr. Eric Woodard, MD, is involved with a research group at MIT developing this approach. They use a biodegradable scaffold that mimics the body's natural extracellular matrix. This scaffold provides structural support and a nurturing environment for the stem cells.

These scaffolds can be enhanced with proteins and growth factors. These additions protect the stem cells and guide their development into neural tissue. The scaffold itself breaks down and is absorbed by the body as it integrates with healthy tissue. This combination approach is a very active and exciting area of spinal cord research.

Clinical Trials and the Future of Spinal Cord Treatment

Cutting-edge research is rapidly moving into human clinical trials. Dr. Eric Woodard, MD, reveals that an FDA-approved safety trial is already underway. The first patient received a combination stem cell and scaffold implant just three weeks prior to the interview. This marks a significant milestone in translating laboratory research into clinical practice.

Dr. Anton Titov, MD, and Dr. Woodard discuss the realistic timeline for these therapies. Tissue engineering techniques are expected to become adaptable for spinal cord injuries in the future. This technology holds the potential to dramatically change the outlook for patients within the next decade.

Avoiding Unproven Treatments for Spinal Cord Injury

Patients and families devastated by spinal cord injury are vulnerable to misinformation. Dr. Eric Woodard, MD, acknowledges the emotional drive to seek any possible treatment. He specifically warns against disreputable "stem cell clinics" that offer unproven therapies. These treatments often lack scientific evidence and rigorous testing.

Dr. Eric Woodard, MD, emphasizes that true stem cell technologies must be scientifically proven before public dissemination. Dr. Anton Titov, MD, reinforces the importance of seeking evidence-based care. Patients should pursue a medical second opinion to ensure their diagnosis is correct. A second opinion also helps confirm they are selecting the most advanced, legitimate therapies available.

Full Transcript

Spinal cord injury treatment with stem cells holds much promise of changing life quality for patients with spinal cord injury. A leading Boston-based spine surgeon shares his vast experience of treatment of spinal cord injury. A neurosurgeon explains latest advances in tissue engineering technology.

Scaffolding and stem cell therapy will likely change dramatically outlook for spinal cord injury in the next decade. There are new advances in spinal cord tissue engineering.

Stem cell treatment of spinal cord injuries involves tissue scaffolding to feed stem cells with growth factors and nutrients. Stem cell–based therapies for spinal cord injury require structural support to quench secondary inflammation.

Spinal cord injury treatment with stem cells is rapidly advancing into clinical practice. Medical second opinion after spinal cord trauma ensures that diagnosis is correct and complete. Medical second opinion also helps to select advanced therapy for spinal cord injury.

Get medical second opinion on spinal cord injury and be confident that your treatment is the best. Spinal cord injury treatment with stem cells and tissue engineering brings new hope to patients and their families.

Repair of injured spinal cord by using biomaterial scaffolds advances spinal cord injury treatment and rehabilitation. Advances made in treatment of spinal cord injuries give hope for better clinical outcomes.

Dr. Anton Titov, MD: Will stem cell therapy cure spinal cord injury?

Dr. Eric Woodard, MD: We hope it will help to regrow injured spinal cord and reverse effects of secondary inflammation.

Dr. Anton Titov, MD: Spinal cord injury. This is another very big topic. Oftentimes patients and families are devastated physically and psychologically. Desperate patients often get treatments that are not evidence-based.

Dr. Anton Titov, MD: You deal a lot with the spinal cord injury. This is one of your major clinical interests. What is most beneficial for patients with spinal cord injury in the short term?

Dr. Anton Titov, MD: What works for spinal cord injury in the long term?

Dr. Eric Woodard, MD: It is a fascinating question. Again, entire careers are spent just studying spinal cord injury.

In my former position at Harvard at Brigham and Women's Hospital, I was Director of the Spine Division. We saw, unfortunately, a significant number of spinal cord injuries. We saw both cervical and mid-thoracic spinal cord injury.

Spinal cord injury treatment is changing, fortunately. The traditional treatment of spinal cord injury has been purely supportive. By that I mean generally supporting the blood pressure and the other medical and physiologic functions of the patient who's been injured.

We also focused on removing any compressive lesions, such as fractured bone or dramatically herniated disc from the cord. The goal is to remove the pressure off the cord and give it the best environment to heal. Also it is important to keep blood pressure adequate. These types of things.

Those were the mainstays of treatment - supportive. A number of years ago the addition of steroids was added. It was the attempt to reduce some of the swelling and some of the additional inflammation. Inflammation occurs after spinal cord injury.

Inflammation in itself can cause further injury after the initial spinal cord injury.

Dr. Anton Titov, MD: Like a compartment syndrome, in a sense...

Dr. Eric Woodard, MD: In a sense, you are right. There is the initial injury. This, for example, is 10% of the spinal cord. Then there is additional 40% of the spinal cord is injured just due to the inflammation.

In theory, if you can turn off the inflammation, called secondary injury, you may be able to save more of the viable cord.

Dr. Anton Titov, MD: In super acute phase...

Dr. Eric Woodard, MD: Correct, this is immediately peri-trauma. Immediately after the event that caused spinal cord injury. A number of folks have been interested because of experimental models in high-dose steroids. They also aimed to reduce this inflammation.

Over the years some excellent clinical trials have been performed to assess effectiveness of steroids. Unfortunately, steroids given after the spinal cord injury only minimally affect outcome. In fact, if you treat spinal cord injury with steroids for extended period of time immediately after the injury, steroids cause more complications than benefit.

There was a lot of enthusiasm years ago for steroid use. But the study showed that it doesn't benefit significantly outcomes. Prolonged steroid use after spinal cord injury causes a higher degree of serious complications. For that reason in the United States now steroids, high-dose steroids in spinal cord injury are decreasingly used.

There has been a lot of interest in the last ten years in trying to re-grow spinal cord tissue with technologies involving stem cells. Stem cells, as you know, are specialized cells within our body that can become pretty much any tissue. They can become brain tissue, skin tissue, muscle tissue if they are stimulated in the correct environment.

They are very specialized, early cells, very similar to the cells of when we were embryos. Stem cells have been extensively studied. It is an entire field of study now. Stem cell application to spinal cord injury has had a lot of interest.

In some areas there is a lot of stem cell research happening. I know in China there has been a lot of work and in Europe there has been a lot of work. Doctors are trying to adapt stem cell injection into acute spinal cord injury, spinal cord bruises or contusions.

One of the problems is the inflammation that occurs right after the injury. I alluded to the inflammation when we talked about steroids. Inflammation is almost toxic, that is why it kills more of the normal spinal cord. Inflammation also kills the stem cells.

Injecting stem cells acutely into the contusion has not been shown to significantly improve the situation.

Dr. Anton Titov, MD: The trials you refer to were done by injection of the stem cells into spinal cord.

Dr. Eric Woodard, MD: Correct, stem cells injections. There have been some clinical trials looking at sub-acute and more chronic stem cell injection. That seems to have a bit more favorable outcome. But much in the spinal cord damage has already way past at that time. Most damage has already happened in sub-acute phase.

A number of groups are looking at a process known as tissue engineering. In tissue engineering the stem cells are combined with artificial extracellular matrix or a scaffold. This mimics the supporting environment of normal tissue.

I have been fortunate to be associated with one group here at MIT in Boston. Many things can be added to these types of scaffold. Scaffolds are biodegradable, they break down, they are absorbed by the body, they integrate into the normal tissue.

Many additional factors can be added to the scaffold. Proteins and growth factors can be added to the scaffold. Also a variety of factors that are protective and nutritional for the stem cells can be added. They will additionally influence their development into neural tissue.

A combination of both scaffold and tissue engineering technology and stem cells are very active area of research. In fact, we have just started an FDA safety trial and the first patient had the combination scaffold injected into spinal cord injury site just three weeks ago.

Stem cell and tissue engineering are very up to date, exciting area of research. In the future tissue engineering techniques will be adaptable to spinal cord injuries.

Dr. Anton Titov, MD: Perhaps it is also very important to emphasize this important point. Stem cells are such actively discussed in the media. Nevertheless around the world many patients are offered treatments that are not based on the actual scientific evidence. That unfortunately includes a lot of stem cell-related therapies.

Dr. Eric Woodard, MD: That is correct, there are a lot of disreputable "stem cell clinics" unfortunately. People who are emotionally devastated by spinal cord injuries will flock to any possibility of improvement. I can understand that.

But stem cell technologies need to be rigorously and scientifically proven before they are widely disseminated to the public. Spinal cord injury treatment with stem cells. Video interview with leading spine surgeon scientist. Tissue engineering and stem cells in new clinical trials.