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Ten frequently asked questions concerning cure of spinal cord injury

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    Paulo, i would not wait to get the anterior decompression. A 20% compression is not good for your spinal cord. Transplantations probably would not be done from the anterior direction anyway. They would not expose the spinal cord from the front. They would just remove the compression. Wise.

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      Originally posted by Wise Young
      Paulo, i would not wait to get the anterior decompression. A 20% compression is not good for your spinal cord. Transplantations probably would not be done from the anterior direction anyway. They would not expose the spinal cord from the front. They would just remove the compression. Wise.
      thank's Wise do you know some of the best hospitals in Europa or Italy where can i have this procedure. You teach me that open the chest and an to have anterior decompression with unthetering of the cord is a dangerous surgery .


      Paolo

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        Originally posted by flashfox
        thank's Wise do you know some of the best hospitals in Europa or Italy where can i have this procedure. You teach me that open the chest and an to have anterior decompression with unthetering of the cord is a dangerous surgery. Paolo
        Paulo, do you have anterior compression of your cord or are you referrring to the syrinx? Wise.

        Comment


          Originally posted by Wise Young
          Paulo, do you have anterior compression of your cord or are you referrring to the syrinx? Wise.
          anterior compression 10/20% caused from a bone fragment of the vertebra slipped in ahead after the fracture with modification of the physiological curve

          Paolo

          Comment


            Originally posted by flashfox
            anterior compression 10/20% caused from a bone fragment of the vertebra slipped in ahead after the fracture with modification of the physiological curve
            Paulo, I am not up on the latest surgeons in Italy. Let me try to find out for you. Wise.

            Comment


              Quote Wise: "The second generation therapies are beginning to be tested in clinical trials."

              What are some examples of second generation therapies now being tested?

              Thanks

              Comment


                Originally posted by Christopher Paddon
                Quote Wise: "The second generation therapies are beginning to be tested in clinical trials."

                What are some examples of second generation therapies now being tested?

                Thanks
                They are just beginning to be applied.

                Cethrin is an example of a second generation therapy of anti-Nogo therapies. It is going through phase 1 trial now. I am looking forward to IN-1, chondroitinase, and nogo receptor blockers being applied soon. I understand that Novartis has started recruiting patients (chronic) for their phase 1 IN-1 trial.

                Over half a dozen different cell types have been transplanted to the spinal cord, e.g. fetal spinal cords (UF Gainesville), fetal porcine neural stem cells (Wash U & Albany), fetal OEG (Beijing), adult OEG (Brisbane), nasal mucosa (Lisbon), bone marrow stem cells (Sao Paulo, Zhengzhou), fetal neural stem cells (Moscow and Novosibirsk), and others. Activated macrophages (Proneuron) are now in Phase 2 in the United States.

                Henreich Cheng has submitted a paper for publication concerning his five year experience placing peripheral nerve grafts and a growth factor cocktail on the spinal cord. I recently heard of a center in Tienjin (China) that has transplanted adult Schwann cells into 8 patients and they are finding improvements in patients. There is intense discussions right now of the phase 2 trials of cell transplants combined with growth factors.

                Wise.

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                  Wow, thanks Dr Young for keeping us up to date. I know that in the past you've referred to peripheral nerve grafts as a possible solution to return of bowel and bladder control. All of these trials are interesting but hopefully the paper on this will be published soon. Mike
                  T12 Incomplete - Walking with Crutches, Injured in Oct 2003

                  Comment


                    Originally posted by MikeC
                    Wow, thanks Dr Young for keeping us up to date. I know that in the past you've referred to peripheral nerve grafts as a possible solution to return of bowel and bladder control. All of these trials are interesting but hopefully the paper on this will be published soon. Mike
                    Mike, peripheral nerve bridging has been done in Europe and the China for many years. Zhang Shao-Chen in Shanghai, for example, has been doing bridging from spinal roots above the injury site to the bladder for over a decade and he believes that works. To my knowledge, this is not being practiced in the United States yet.

                    It is important to understand, however, that peripheral nerve bridging (like tendon transfer) involves some loss of function above the injury site. A lot depends on the judgment of the surgeon and the question is whether the benefits for the bridging are worth the loss of that function and the risks of surgery. In some cases, I believe that the benefits are worth the loss of some function above the injury site and the risks of surgery are relatively low.

                    Wise.

                    Comment


                      Originally posted by Wise Young
                      To my knowledge, this is not being practiced in the United States yet.

                      A lot depends on the judgment of the surgeon and the question is whether the benefits for the bridging are worth the loss of that function and the risks of surgery.

                      Wise.
                      Dr Young, I agree that I would only have such a procedure after close consulation with the surgeon who has a proven track record. Do you have any indication that someone in the US might start doing this type of procedure in the near future?

                      Mike
                      T12 Incomplete - Walking with Crutches, Injured in Oct 2003

                      Comment


                        Originally posted by MikeC
                        Dr Young, I agree that I would only have such a procedure after close consulation with the surgeon who has a proven track record. Do you have any indication that someone in the US might start doing this type of procedure in the near future?

                        Mike
                        I believe that the peripheral nerve grafting will come from plastic surgeons rather than neurosurgeons or orthopedic surgeons. They are already doing these procedures for the facial nerve. What surgeons do emanate from their training. For many years now, the peripheral nerve field had been dominated by plastic surgeons for most of the body, shared between plastics and orthopedics for the hand, and the neurosurgeons do the spinal roots and the some of the cranial nerves. So, I will look in the plastic surgery literature and see who is reporting such procedures. I know a couple of plastic surgeons who are doing spinal cord injury research. Wise.

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                          Hello:

                          I'm going to Beijing on September for the OEC surgery and I would like some feedback from anyone that had this procedure and if recover any movement back.

                          I'm a quad C4-5 incomplete.

                          Comment


                            Dr Young, just wanted you to know that I saw your post and will be interested in what you find in the literature on plasic surgeons. I'm in no rush - like I said I'll investigate thoroughly before giving up something through a nerve graft. Mike
                            T12 Incomplete - Walking with Crutches, Injured in Oct 2003

                            Comment


                              MikeC, one very good plastic surgeon who has been doing quite a lot of nerve rerouting is Julia Terzis who is Director of Microsurgical Program at the Eastern Virginia School of Medicine in Norfolk, Virginia. http://jkterzis.com/

                              Wise.

                              Comment


                                Please help...

                                Recently (last Saturday) a close friend of mine had a severe accident rafting down a river near San Antonio, TX. She suffered a spinal cord injury. The MRI and CAT scan came back negative for a broken back or neck. Thats the good news. There is swelling on her spinal cord and she has no feeling from her belly button down. She did have steroid shots immediately after the accident. I saw her yesterday and she seemed to be in decent spirits.

                                I am seeking advise for what is going to happen next... what types of therapy, medicines, etc... Also answers to thinks like... how long (average) and of course will she walk again?

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