July 2010

If you ever suffer a major injury in metro Atlanta and are still able to talk, remember to say, "take me to Grady."  This is important because treatment at  a Level 1 trauma center significantly improves prospects of successful outcome. A recent article on "The Effects of Trauma Center Care, Admission Volume, and Surgical Volume on Paralysis After Traumatic Spinal Cord Injury" published in Annals of Surgery  concludes that trauma center care is associated with reduced paralysis after traumatic spinal cord injury, perhaps because of greater use of spinal surgery.  Hospitals that do not have trauma centers follow national guidelines to triage patients to trauma centers less than half the time, keeping patients in their facilities when they should be transported to a Level 1 trauma center.

So, as I said earlier, if you are in a serious accident within a 100 miles radius of Atlanta, remember these four words: "take me to Grady."

Spinal cord injury survivors may someday have more hope for functional recovery. An article in Brain by James Fawcett at Cambridge University summarizes research papers reporting functional recovery following a variety of treatments. These have included interventions that affect myelin inhibitory molecules and their receptors, or inhibitory chondroitin sulphate proteoglycans, and treatments in which the regenerative potential of axons has been stimulated through growth-factor receptors or manipulation of internal signalling pathways. The article suggests  it is probable that much of the useful recovery seen following treatment of animals with partial spinal cord lesions is due to the stimulation of plasticity.  However, there is a wide gap between basic research with lab animals and clinically useful treatments.

Survivors of spinal cord injury face life-long problems with mobility.  As an attorney representing spinal cord injury survivors, I have often addressed needs for adapted vehicles in life care plans. Now there is news of the first factory-built, wheelchair accessible car – the MV-1 – which is a milestone for the 14 million American adults who use wheelchairs or other mobility devices. We may list this in future life care plans for survivors of catastrophic spinal cord injury who are paraplegic or quadriplegic.