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Research could overcome spinal-cord injuries

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What's the most catastrophic illness that can befall us? To me it's a spinal-cord injury (SCI) that results in total paralysis. During a recent visit to Israel, I interviewed Dr. Shimon Rochkind, a world-renowned neurosurgeon at the Tel Aviv University Sourasky Medical Center and an expert on SCI.

Every year, 12,000 North Americans sustain spinal-cord injury. The people involved are usually under the age of 30 and 80 per cent are males. Some, like Christopher Reeve of Superman fame, fall from a horse. Others dive into shallow water or are involved in car accidents.

Rochkind has spent his life trying to accomplish what's said to be impossible. Time and time again, we've been told some tissues of the body can regenerate but never the spinal-cord. Christopher Reeve received the best treatment money can buy but he never walked again. What I witnessed in Rochkind's laboratory shows that what we've accepted as gospel for centuries is no longer true.

Rochkind first showed me video of a rat running around his cage. Later, he surgically removed half a centimetre (a quarter of an inch) of the rat's spinal-cord, which resulted in complete paralysis of the hind legs. Normally, without a complete spinal-cord the rat would never walk again.

But video taken several weeks later revealed the rat was now moving his legs. It was not doing so as perfectly as before, but good enough to get quickly around his cage.

So what had Dr. Rochkind done to partially reverse the paralysis? He had to overcome several problems: first, to bridge the gap between the severed nerve, then to nourish the nerve and stimulate its growth. Finally, to encourage the first step as one does with an infant.

The first solution was to develop what Rochkind calls a "genetically engineered implant," thousands of times more difficult than designing a hip replacement. This meant experimenting with several different types of tissue. One implant involved human spinal-cord cells. But a major advance was his eventual discovery it was possible to use cells taken from the lining of the adult human nose.

What tissue will be used in the final implant is unknown. But at the moment, it's composed of a highly complex assortment of hyaluronic acid, neuronal growth factor, antioxidants such as vitamin C and other ingredients. This mass of material is encompassed in a soft, biodegradable tube placed between the severed nerve endings. This acts as a scaffold for the implant.

Had he lived, would Reeve have walked again? Rochkind is convinced the possibility will happen in his lifetime. It may not be the perfect walk but patients with these injuries will not be immobilized for the rest of their lives.

Not all nerve injuries, however, are spinal-cord ones. For instance, some involve the peripheral nerves of the arm or legs. It's the type of injury that cripples thousands of soldiers fighting in Afghanistan and other war sites.

Rochkind's laboratory is making great advances with these injuries. The big problem has always been the rapid loss of muscle mass once a nerve is injured. After all, what's the use of regenerating the nerve if there's no muscle tissue left to function?

For these peripheral injuries, Rochkind is using laser phototherapy, which provides an immediate protective effect. This therapy not only helps to prevent muscle loss but also helps to regenerate nerves and aids in restoring muscle mass. Laser therapy is given two hours a day for 21 days. The sooner it is started, the better the results.

I left Israel impressed and amazed at how this tiny country with no natural resources, fighting for its very existence since 1948, could accomplish so much in research. I'd predict Dr. Rochkind's innovative work is headed for a Nobel Prize in medicine.

Republished from the Winnipeg Free Press print edition May 27, 2011 A1

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