What is a Spinal Cord Injury?
Spinal cord injuries are injuries that occur to any level of the spinal cord. Although the hard bones of the spinal column protect the soft tissues of the spinal cord, vertebrae can still be broken or dislocated in a variety of ways and cause traumatic injury to the spinal cord. Spinal cord injuries vary in their severity, but almost inevitably lead to various forms of compromised functionality as the spinal cord is in effect the main pathway for information to travel around the human body. Precisely what body functions are impaired by the injury will depend on the area of the spine that has been damaged and the extent to which the spine has been affected. Although serious impacts such as falls and motor vehicle accidents account for many spinal cord injuries, tumors growing close to the column can also damage sensitive nerve tissue and have the same effects.
For decades scientists have been working to try and find a way to remedy the various ailments that spinal cord injuries can bring, but with limited success. However, in recent years a pioneering new technology has emerged that is helping thousands of people around the world regain part, if not all, of their previously lost mobility. That treatment is the use of stem cells.
What are Stem Cells and Stem Cell Treatments?
Stem cells are found in all multi cellular organisms and are characterized by their ability to differentiate into a diverse range of specialized cells when they divide and renew themselves. They are remarkable for their ability to regenerate themselves into almost any other human cell. Their use in the treatment of various diseases and conditions, from Leukemia to Multiple Sclerosis, is now becoming more common. Depending on the condition, stem cells can be transplanted into the patient to help renew and regenerate previously damaged cells, giving patients renewed hope when, before, no reliable treatment existed.
This principle is now being applied to the treatment of spinal cord injuries using stem cells, and in instances where the patient has not experienced a complete spinal cord injury, i.e. a complete severing of the spinal cord leading to a loss of function below the ‘neurological’ level. There has been great success in helping patients recover greater sensory and physiological ability.
Spinal Cord Injury: How Stem Cell Treatment Works
When there is trauma to the spinal cord, myelopathy (damage to the fibres that carry messages to and from the brain) has occurred. These ‘myelinated fibre tracts’ are the focus of stem cell treatment, and are the nerve cells that the treatment helps to regenerate. The procedure usually follows three phases and usually requires no longer than a period of around five weeks in medical care for monitoring:
Phase one involves the harvesting of stem cells. The cells are extracted from a fetus’s umbilical cord. They are then put through a process whereby they are isolated and purified before they are finally cultured to be suitable for clinical use.
Phase two is the transplantation of the stem cells. This is done in one of three ways:
1) Lumbar puncture – a procedure used where stem cells can be injected directly into the spinal column.
2) Intravenous injection- stem cells are injected into the patient’s vein.
3) Tissue injection – direct injection into target tissues.
Phase three involves the monitoring of the patient to make sure there are no adverse side effects. The only side effects reported to date were caused by the lumbar puncture, and not the stem cell treatment itself, with only 15% of patients reporting mild headaches. During the time under medical supervision, patients undergo various physiotherapy activities and other treatments as necessary.
Stem Cell Research and Treatment in China
China is fast becoming a world leader in stem cell research, and is now a major centre for the stem cell treatment of many diseases and conditions. The Chinese government has poured many millions of dollars into research on regenerative medicine, and that investment has really borne fruit in the last few years. As a result of this expanded investment, Chinese contributions to scientific journals on regenerative medicine topics leapt from 37 in year 2000 to 1,116 in 2008, exceeded only by the contributions of experts in the USA, Germany, Japan and the UK.
The government has also aggressively recruited high-caliber scientists trained abroad in pursuit of its ambition to become a world leader in the field. Indeed, the McLaughlin-Rotman Centre for Global Health commented that, “the government’s policy of attracting highly educated Chinese nationals back to China has contributed significantly to the country’s success in the field.” The authors were “amazed that almost all the top Chinese researchers in the regenerative medicine field had been educated in the US and the UK and gained extensive working experience there in cutting edge research.”
Although in the past treatment in China might have been considered risky due to lax health and safety laws, recent years have seen an increase in legislation protecting the patient, and improving the functionality of clinics. Since 2009, proof of safety and efficacy through clinical trials is required by China’s Ministry of Health for all stem cell and gene therapies, ensuring that Chinese clinics meet international standards in their qualifications and methodology. As of January 2010, about 1,500 patients had received this treatment for spinal cord injury at one Beijing clinic alone, including roughly 1,000 foreigners.
In addition to this, China has long held a place at the forefront of stem cell research to treat all manner of conditions. Some of China’s notable contributions to stem cell research are:
- By transferring the nucleus of a human skin cell into the immature ovum cell of a rabbit, researchers from a Shanghai hospital successfully produced embryonic human cells.
- China to date has created at least 25 human embryonic stem cell lines (some estimate over 70 stem cell lines), four of which are of a specialized type that at that time only two other groups worldwide had managed to create.
- Harboured several human tissue types, created artificially, including blood vessel, tendon, bone, cartilage, skin, cornea and muscle fibre.
Furthermore, Chinese researchers are currently involved with a myriad of projects to help aid patients through regenerative medicine and stem cell therapy. Below are several projects underway within Chinese institutions:
- ChinaSCINet, a consortium of 27 medical facilities, are starting phase 2 clinical trials to test the efficacy and safety of using cord blood stem cells and oral lithium to treat about 40 patients with spinal cord injuries.
- Clinical trials are underway on the use of stem cell therapies to treat patients of heart attacks, artery obstruction, and liver and neural diseases.
- Studies are underway on the potential use of stem cells to treat heart, liver and blood diseases, eye cataracts, and to combat aging.
Success Stories from the Treatment of Spinal Cord Injuries in China
Many people of all ages and with varying degrees of injury have received stem cell treatment in China over the last few years. It is important to remember that not every patient will react as well as others, and that the age of the patient and the severity of the injury greatly affect the chances of recovery. However, there have been many success stories from both Chinese citizens and foreigners.
Before her treatment began in January 2006, Ms. Pai, 38, from Shenyang couldn’t move her body below the injury site, and was unable to control her bowel movements. Within 8 months of the treatment she regained movement in both her legs, could bend her knees (although the toes of one foot were still paralyzed) and was even able to walk with crutches.
Razvan Iordache, a Romanian citizen aged 30, travelled to China for several bouts of stem cell treatment following an accident while diving into a river that left him paralyzed from the neck down. Following his treatments, Razan reported in 2008 that not only could he now use his arms almost normally, and could feel pain in several of his fingers, he could “even feel warm and cold” sensations. He went on to add the following: “Now I can control my urine for 10 minutes and the sensation for both urine and stool is much better. Generally, my entire body is more powerful than before.”
Donald Maricelli, a 54 year old US citizen, suffered a spinal cord injury following a fall in 2002. He underwent an operation to correct his lack of sensation in his lower body, however there were complications and Donald was left in a worse state than before. Before arriving for treatment in China, he was still unable to walk unaided. Following the treatment, which commenced in November 2007, Donald has made significant improvements. He regained sensation throughout most of his abdomen, and the sensation in his legs also improved. Particularly important, the sensation on the bottom of his feet came back, helping him to walk without tripping. Most important to Donald was that he regained control and strength in his left leg, allowing him to walk significant distances and stand for prolonged periods of time.
There are many more success stories from patients who have received this pioneering treatment to help correct varying degrees of spinal cord injury. However, it is always important to remember that not all patients recover the same functions in the same period of time. A lot of hard work goes into the post treatment rehabilitation, and it takes great drive, determination and ambition to enable the body to get back to more regular functionality. However, the work being done by scientists and clinics in China has shown time and again that stem cells hold a very important key to the future of helping people with spinal cord injuries recover their lost functions. Every month, more and more people are travelling to various cities around the country that offer different packages of treatment depending on precisely what injury has been inflicted. The level of service has improved greatly in recent years, and continues to improve each month, meaning that those unfortunate enough to have suffered spinal cord injuries need no longer feel theirs is a lost cause. There is a very real chance that the standard of living of any patient can be improved with little pain, little hospital time, and a little motivation. The current evidence shows that stem cell therapy for spinal cord injuries is the way forward.