Over years of representing clients with spinal cord injuries resulting in paraplegia or quadriplegia, I seize upon any new development that offers hope for improving the quality of their lives and function.
For several years I have seen articles about the use of stem cells to mend damaged spinal cords. One of the most promising ideas has been the use of olfactory nerve stem cells from the patient’s own nose.
Now there is a report of this idea moving from animal research to clinical implementation with a human patient. The effect on our representation of paralyzed clients is that we have a new item of potential medical expense to seek that provides hope from recovery.
A Polish paralyzed man is able to walk again after a new therapy that involved transplanting cells from his nasal cavity into his spinal cord.
Derek Fidyka, 40, was paralyzed from the chest down when he was stabbed repeatedly in the back in a knife attack in 2010. Thanks to a pioneering therapy, he can now walk using a frame. The treatment, a world first, was carried out by surgeons in Poland who worked with scientists in London.
He said walking with the support of a walker was “an incredible feeling”, adding: “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.
Professor Geoff Raisman, chair of neural regeneration at University College London Institute of Neurology, led the London research team. He said what had been achieved was “more impressive than man walking on the moon.”
The treatment used olfactory ensheathing cells (OECs) that are specialist cells that form part of the sense of smell. OECs act as pathway cells that enable nerve fibers in the olfactory system to be continually renewed. In the first two operations, surgeons removed one of the patient’s olfactory bulbs and grew the cells in culture.
Two weeks later they transplanted the OECs into the spinal cord, which has been cut through in the knife attach apart from a thin strip 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 made above and below the injury. Four thin strips of nerve tissue were taken from the patient’s ankle and placed across an 8mm (0.3 inch) gap on the left side of the cord.
The scientists believe the OECs provided a pathway to enable fibers above and below the injury to reconnect, using the nerve grafts to bridge the gap in the cord.
Before the treatment, Mr. Fidyka had been paralyzed for nearly two years and had shown no sign of recovery despite many months of intensive physiotherapy. He has also been going through an exercise program for five hours per day, five days a week. Fidyka first notices that the treatment had been successful after about three months when his left thigh began to put on muscle.
Six months after surgery, Fidyka was able to take his first tentative steps along parallel bars, using leg braces and the support of a physiotherapist. Two years after the treatment, he can now walk outside the rehabilitation center using a frame. He has also recovered some bladder and bowel sensation and sexual function.
Dr. Pawel Tabakow, consultant neurosurgeon at Wroclaw University Hospital, who led the Polish research team, said “It’s amazing to see how regeneration of the spinal cord, something that was though impossible for many years, is becoming a reality.”
This has not yet been approved by regulatory agencies in the US, but it is an advance that gives hope for the future.
Ken Shigley is an Atlanta-based personal injury and wrongful death trial lawyer. He is past president of the State Bar of Georgia, chair-elect of the American Association for Justice Motor Vehicle Collision, Highway & Premises Liability Section, and a board certified civil trial attorney of the National Board of Trial Advocacy.