Brachial Plexus Injury Repair Trials to Start

Treatments, Rehabilitation, and Recovery
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Christopher
Posts: 845
Joined: Wed Jun 18, 2003 10:09 pm
Injury Description, Date, extent, surgical intervention etc: Date of Injury: 12/15/02

Level of Injury:
-dominant side C5, C6, & C7 avulsed. C8 & T1 stretched & crushed

BPI Related Surgeries:
-2 Intercostal nerves grafted to Biceps muscle,
-Free-Gracilis muscle transfer to Biceps Region innervated with 2 Intercostal nerves grafts.
-2 Sural nerves harvested from both Calves for nerve grafting.
-Partial Ulnar nerve grafted to Long Triceps.
-Uninjured C7 Hemi-Contralateral cross-over to Deltoid muscle.
-Wrist flexor tendon transfer to middle, ring, & pinky finger extensors.

Surgical medical facility:
Brachial Plexus Clinic at The Mayo Clinic, Rochester MN
(all surgeries successful)

"Do what you can, with what you have, where you are."
~Theodore Roosevelt
Location: Los Angeles, California USA

Brachial Plexus Injury Repair Trials to Start

Post by Christopher »

Well guys, this community might be ancient history soon. Prof Raisman is finally starting up on his trials. The next year will be very interesting to try and follow up on his work. We'll be the last of a disappearing race, they might have to put us all on the "endangered species" list. That would be nice.

Chris


http://news.bbc.co.uk:80/2/hi/uk_news/wales/6274960.stm
====================================

Spinal injury 'repairs' on trial


Hywel Griffith
BBC Wales health correspondent
Friday, 6 July 2007


Trials are to begin on the first patients as part of cell research which could help thousands of people paralysed in accidents. Welsh charity Trust PA has helped to fund scientists who hope to repair the spinal cord by transferring cells from the nose to make it grow back.

If successful, the treatment could mean patients taking back control of their bodies.

The research is being carried out by the Institute of Neurology in London.

Simon Morris, from Sully in the Vale of Glamorgan, has been learning to rebuild his life since an accident 10 years ago left him paralysed from the chest down.


To have it all taken away in an instant - it was a lot to take in
Simon Morris

A simple fall while on holiday in Greece was enough to damage his spine. He spent 16 months in hospital, and now depends on a wheelchair.

"I was in the Navy prior to my accident so I was quite active. I enjoyed a very good social life, " said Mr Morris.

"Increasing my mobility would be brilliant. Any little gain, any slight gain would mean a great deal for me - not just for me, but for other people with spinal injuries."

Animal models

At the moment, there is no treatment for Mr Morris' injuries.

But Professor Geoffrey Raisman, from the Institute of Neurology, have found that cells found in the nose can be transplanted to the spinal cord to help it re-grow.

So far, tests have been on animals but Professor Raisman said they were now ready for trials with humans.

"We've got to the point where in animal models - in rats - we can get these cells from the adult," he said.

"We can transplant them into injuries of the spinal cord, of the spinal root, and the nerve fibres grow back and function returns.

"Now, what we're trying to do is to transfer this to human application," he added.

'Important things'

"The stage we're at we already know, and others have shown, that these cells are present in humans.

"We are trying to learn how to grow them from what is actually volunteer samples and then we hope to transplant them into a group of highly-defined injuries in 10 to 12 patients."

The research is expensive and is being helped by a small Welsh charity.

Trust PA was set up in memory of Paul Andre (PA) Blundell, a rugby player from Cardiff, who was paralysed after an accident on the pitch.

After his death five years ago, his parents decided to put their efforts into supporting research to repair the spinal cord.

His mother Gerri Blundell said: "We have the most amazing hope because the work of Geoffrey Raisman has 40 years of research behind it."

"As far as Paul Andre was concerned, for him it was a chance that he would possibly walk again before he was 40.

"He thought that was worth going for and I think in terms of other families, that hope is one of the most important things to give them something to live for at all."

Developing the treatment could still take years, but the fund-raising will help the research.

This has including raising money at events such as last weekend's British speedway grand prix at the Millennium Stadium.
User avatar
Christopher
Posts: 845
Joined: Wed Jun 18, 2003 10:09 pm
Injury Description, Date, extent, surgical intervention etc: Date of Injury: 12/15/02

Level of Injury:
-dominant side C5, C6, & C7 avulsed. C8 & T1 stretched & crushed

BPI Related Surgeries:
-2 Intercostal nerves grafted to Biceps muscle,
-Free-Gracilis muscle transfer to Biceps Region innervated with 2 Intercostal nerves grafts.
-2 Sural nerves harvested from both Calves for nerve grafting.
-Partial Ulnar nerve grafted to Long Triceps.
-Uninjured C7 Hemi-Contralateral cross-over to Deltoid muscle.
-Wrist flexor tendon transfer to middle, ring, & pinky finger extensors.

Surgical medical facility:
Brachial Plexus Clinic at The Mayo Clinic, Rochester MN
(all surgeries successful)

"Do what you can, with what you have, where you are."
~Theodore Roosevelt
Location: Los Angeles, California USA

Re: Brachial Plexus Injury Repair Trials to Start

Post by Christopher »

This helps for a good basic understanding of how this science works and the nature of the repair.

Chris


FYI - Prof. Raisman speaking on his trials from 2 1/2 years ago...

http://www.ucl.ac.uk/media/library/spineusa
===================================

Spinal repair pioneer Professor Geoffrey Raisman speaks on the next steps in spinal repair science

18 January 2005

The first clinical trials seeking to repair spinal cord injury on a pilot roup of selected patients are set to begin at University College London (UCL) within the next three years, says Professor Geoffrey Raisman, director of the newly established Spinal Repair Unit at UCL. Professor Raisman will be setting out his vision for the future in New York on Thursday 20th January, at the US launch of the Campaign for UCL, a major campaign with the objective of raising funds necessary to support projects that include development of the Spinal Repair Unit.

Professor Raisman was one of the first neuroscientists whose work in stem cell research has raised the real possibility that spinal cord injuries, long considered incurable, could be repaired. The work of the team holds out significant hope that spinal cord patients will eventually be able to regain much of the ability to move that they have lost. For paraplegic patients this could lead to a return of sensation and movement to some leg muscles, potentially allowing them to stand and making movement easier, while tetraplegics (patients with spinal injury high in the neck region), could recover touch sensation and movement of the hands, and regain the ability to dress, feed and clean independently.

Professor Raisman's key discovery was that there is one part of the nervous system, a region in the nasal cavity concerned with the sense of smell, in which nerve fibres are in a state of continuous growth throughout adult life. Working at the National Institute for Medicial Research in London, Raisman's team transplanted cells from this region into the injured spinal cord of laboratory rats, and found that the cells had a remarkable capacity to integrate into damaged pathways, laying a 'bridge' over the gap in the nerve fibres caused by injury.

The team has now moved to UCL to attempt to transfer that technology from rats to humans, working with patients at the National Hospital for Neurology and Neurosurgery in London , and it is anticipated that the preparatory work to begin trials will be complete within two to three years.

"For many years these injuries were considered incurable, and they are still are incurable," says Professor Raisman, "But I believe that we can now affirm that the door leading to repair of such injuries has now been opened, even if it is for the time being only ajar."

The devastating effects of spinal cord injury are due to disconnection of nerve fibres. Disconnection of the nerve fibres travelling from the brain down to the spinal cord causes paralysis, loss of control of the bladder and bowels, and loss of sexual functions. It can also prevent breathing. Disconnection of nerve fibres travelling up to the brain causes loss of sensation.

"When a nerve fibre is severed it attempts to regrow, like the sprouts arising from the trunk of a felled tree," says Professor Raisman, explaining the technique that his team have discovered. Their failure to do this is not due to an intrinsic inability of nerve fibres to grow, but to the disruption of the pathway along which the nerve fibres need to travel in order to reach their original destinations. This realisation has led to a completely new approach to repairing spinal cord injury.

"It is as if part of a roadway has been washed away by a flooding river. The cars are still able to travel, the drivers remember where they wish to go, the tanks are full of fuel. The situation will not be repaired by adding more cars, or filling up the tanks to overflowing. What is required is to repair the roadway, to lay a bridge over the gap.

"The pathway taken by nerve fibres is a living pathway made up of specialised cells laid out in rows, like the paving stones of a road. When the spinal cord is injured, the pathway cells of the spinal cord are unable to repair themselves. They remain piled up in a great scar. The scar has the value of holding the flood water back but forms an impenetrable barrier to the cars.

"The way out of the impasse came from the discovery that there is one part of the nervous system, and only one, in which nerve fibres are in a state of continuous growth throughout adult life. This is the part of the nervous system concerned with the sense of smell. It is located in the upper part of the lining of the nasal cavity and contains adult stem cells which are capable of regenerating the entire system. The intuitive leap was to transplant cells obtained from this area into the injured spinal cord. What we found was that in laboratory animals the cells have a remarkable capacity to integrate into the damaged roadway, open up the scar, and lay a bridge over the gap.

"The cut nerve fibres at once recognised the bridge, crossed it rapidly, and regenerated to their original destinations. In laboratory animals these transplants resulted in return of important functions such as paw reaching and climbing, and we were the first, and still the only, team to show that this repair resulted in a restoration of the ability to breathe. Very promising ongoing studies are investigating whether this approach can also restore bladder, bowel and sexual functions.

"An especially encouraging feature of these transplants, carried out in laboratory animals, is that the reparative pathway cells can be obtained from tissue samples taken from the adult nasal lining by a technique which does no permanent damage, since the system, like skin, contains adult stem cells and is in a state of continuous self renewal. If this technique can be transferred to humans, the patient can be his/her own cell donor. This will avoid the need to use embryonic tissue, to find donor individuals, foreign stem cells, or to use powerful designer drugs with unknown side-effects.

"The ability to reconnect spinal cord nerve fibre is only a beginning. Success will open the door to a number of other conditions where nerve fibres are damaged. These include some major forms of stroke, as well as blindness and deafness caused by nerve injuries.

"There is a long way to go, and we do not wish to raise false hopes in patients who are living with spinal cord injury. However, our work to date clearly indicates that, contrary to received wisdom, the spinal cord does have the potential to repair itself. That is why we believe that human trials are the logical next step."

"Professor Raisman and his team have shown that the repair of the injured spinal cord is now a real possibility," says Professor Malcolm Grant, President and Provost of UCL. "Bringing the team to UCL means that we can now start preparing for the day when the first trials will begin. We all look forward to seeing this promising research translated into successful clinical trials at the earliest possible stage. We are launching our Campaign for UCL in New York this week to showcase and gain support for the groundbreaking research talking place across UCL, of which the work of Professor Raisman's team is one example."
wazza

Re: Brachial Plexus Injury Repair Trials to Start

Post by wazza »

Many thanks for your posts!
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