My Blog List

Spinal Cord Injuries

More than 80,000 Canadians are living with spinal cord injuries and that number is expected to climb.

A new report commissioned by the Rick Hansen Institute marks the first time Canadian health officials have had access to solid numbers on spinal cord injuries, which significantly shorten people's lives and cost billions in health-care costs.

The Urban Futures Institute report estimates 85,556 Canadians have spinal cord injuries. That number is expected to reach 121,000 by 2030.

About 48,243 people with spinal cord injuries are fully paralyzed, while 30,324 can use their arms.

People with spinal cord injuries will spend an average 140 days in hospital and die 15 to 30 years earlier than the average person. That's because they're susceptible to medical complications like urinary tract infections, pressure ulcers, pneumonia and severe depression.

Christopher Reeve, the actor known for portraying Superman who became paralyzed after falling from a horse, eventually succumbed to complications due to pressure ulcers.

In 42% of cases, the cause is a traumatic injury like Reeve's — mostly car crashes and falls. Other common causes include ALS and cancer.

The report estimates the economic cost of traumatic spinal cord injuries is $3.6 billion a year, including $1.8 billion in direct medical costs.

“It is essential to demonstrate to the Canadian public the full cost of SCI, to both individuals and communities, and to demonstrate the benefits of programs that will either reduce incidence or improve the lives of those with SCI so that the wider public will give their support, both in spirit and in funding, of these programs,” the report says.A few weeks before her wedding day, Rachelle Friedman went out for her bachelorette party with some close friends last May. After a night out on the town, the group went to the home of Rachelle's best friend.

The friend playfully pushed Rachelle into the swimming pool — something they'd done to each other many times before — but this time the bride-to-be landed on her head, paralyzing her from her chest down.

In the ensuing six months, Rachelle has worked to adjust to her new reality. Despite the odds and the tragic turn her life has taken, she is "doing awesome," Friedman says in a Monday interview with the "Today" show. She credits her family and her fiancĂ©, Chris Chapman — who says in the segment that the wedding is still on: "I never once thought about leaving her or this situation." As for the friend, whose name Rachelle wants to keep from the press, Rachelle says, "I'm absolutely best friends with the girl…. Blaming her would be ridiculous."

Watch the "Today" show interview with Rachelle Friedman and Chris Chapman:

In a recent interview with ABC News, Friedman recalled more of the accident. "I instantly went stiff and couldn't move," she said. "I weirdly did not panic. I kind of knew exactly what happened, and I floated up to the surface and said, 'Help,' and then my friends called 911."

ABC reports that the doctors at the hospital "quickly determined that Friedman had suffered a C6 spinal cord injury, leaving her unable to walk or even feel sensation beneath her collarbone." Friedman spent nearly three months in the hospital before beginning rehab. It was then, according to ABC, that she learned just how difficult things were going to be.Eli the donkey’s recovery from incomplete quadriplegia could be the most important breakthrough in traumatic spinal-cord injuries and for the stem-cell treatment that restored his mobility—a breakthrough that could impact not only equids but all mammals, including humans.


Quadriplegia is considered incomplete if there is lack of mobility yet some sensory or motor function below the affected area.

On May 13, little Eli was inexplicably savaged by his longtime companion Watson, a jack nearly twice his size. During the attack, Watson grabbed Eli by the neck and shook him furiously like a rag doll, which caused severe spinal-cord trauma midway down his cervical spine.

Over the next few days, as Eli’s spinal cord swelled from the trauma, he experienced a rapid progression of weakness in his front end and hindquarters. With Eli’s condition quickly deteriorating, attending veterinarian Steve Goss, D.V.M., recommended that Eli be sent about 30 miles away to Alamo Pintado Equine Medical Center in Los Olivos, California, for specialized treatment. Alamo Pintado’s staff is credited with overcoming nearly insurmountable odds to save the lives of major stakes winners Thorn Song and most recently Global Hunter (Arg).

Eli arrived at Alamo Pintado on May 18, weak and unstable on all four legs.

“We did a normal treatment of [dimethyl sulfoxide], anti-inflammatories, and hyperbaric oxygen therapy, but he was deteriorating very fast right in front of us,” said Doug Herthel, D.V.M., Alamo Pintado’s founder and chief of staff. “So on May 22, Dr. Carter Judy did an MRI, and that gave us the definitive diagnosis.”

Eli suffered severe trauma to the spinal cord and its blood supply, and the resultant swelling caused compression of the cord within the spinal canal. The diagnosis was delivered by veterinary radiologist Travis Saveraid, D.V.M.

Herthel also sought the opinion of Mike Kistler, M.D., in Cortez, Colorado, a senior member of the American Society of Neuroradiology with more than 25 years of experience in human spinal trauma. Kistler also is a horseman who considered a career in veterinary medicine before turning to human neuroradiology.

“In a human, a comparable injury would have been sustained by diving into shallow water, and the majority of those injuries would have a poor prognosis, with paralysis,” Kistler said.

Kistler’s interpretation of the MRI results was that Eli’s spinal cord had suffered significant bruising and circulation damage, and that the prognosis was poor. Kistler speculated that it would be unlikely that Eli’s injury would resolve on its own, even with traditional treatment. Moreover, because an equid’s overall health declines when it cannot stand, he felt Eli most likely would not survive his injury or its complications.

Under the supervision of internal medicine specialist Tania Kozikowski, D.V.M., Eli received intense supportive care, treatment with anti-inflammatories to reduce the swelling in his spinal cord, and 24-hour-a-day nursing. Yet his condition continued to decline rapidly. On May 24, he lay paralyzed in all four limbs and could not lift his head, urinate, or defecate. He had developed pneumonia and was unable to maintain his body temperature, even with supportive care. Eli was on the verge of death.

Untried theory

Herthel is a pioneer in stem-cell therapy. Over the past 15 years, he has treated more than 5,000 horses with good results. But the bulk of these cases have been tendon and ligament injuries, and more recently laminitis and arthritis. He knew of no research to support the use of stem-cell therapy as a treatment for spinal-cord injuries. But, in theory, it made a lot of sense to him.

“The option to use stem cells was based on what we know adult stem cells can do—promote angiogenesis [formation of new blood vessels] and anti-inflammatory action,” Herthel said. “These injuries to the spinal cord created a lack of circulation and blood supply, which would cause cell death. Eventually, you just end up with a sac of fluid where the injured spinal cord used to be. So our goal was to get rid of the inflammation, similar to what we would use corticosteroids for. But more important were the angiogenesis properties of the mesenchymal stem cells and their ability to protect the cells in the spinal cord and promote the growth of new cells. They also inhibit the formation of scar tissue.”Families of two paralyzed Bay State teens are calling on insurance companies to step up and fund the life-altering therapy that they say has given their sons new hope, but is painfully out of grasp for so many other families.

“It is a shame that insurance doesn’t cover it,” said Michael Brown, who uses donations from the community to pay the $100-an-hour bill for his son, paralyzed Norwood hockey player Matt Brown, to get therapy at Journey Forward, a Canton rehabilitation center.


Brown is among 37 spinal-cord injury patients who are making strides at the nonprofit center founded in 2008 by Dan Cummings, a quadriplegic who was paralyzed in 2000 and told he’d never walk again.

“What we do at Journey Forward is we think outside the box,” said Cummings, 29, who gets around with a walker and says exercise-based therapy has made that possible. “We get paralyzed clients on spin bikes, on total gyms, on treadmills.”

Cummings operates on the belief that with repetitive exercise the neuropathways that are broken in a spinal-cord injury can be retrained, forging connections again between the brain and the spinal cord.

Brown, 16, the high school hockey player who suffered two fractured vertebrae in a game last January, leaving him a quadriplegic, is wiggling his toes now thanks to his work at Journey Forward, he said.

“I’ve got three of them to really go,” he said of the toes on his right foot.

Insurance companies say they don’t cover Journey Forward because their therapies are unproven and their specialists are not licensed physical therapists, but families of patients say that view is shortsighted.

“To put up a barrier to anybody who has suffered a spinal-cord injury or is in a wheelchair and is looking to get out, to put out a financial barrier because insurance doesn’t see it as traditional is just crazy,” said Michael Brown. “There are many of these clients who don’t want to learn how to live in a wheelchair. They want to learn how to get out of that chair.”

No comments:

Related Posts Plugin for WordPress, Blogger...