Spinal Injury and Disease
The greatest challenge
Spinal cord injury presents one of the greatest emotional and physical challenges to ever confront a human. A person with a spinal cord injury must adjust to significant changes in physical functioning, as well as radical changes to his or her independence, ability to participate in family, community and work related activities and, of course, lifestyle.
With ageing, comes a greater level of disability and declining health status, affecting quality of life with more frequent hospitalisation and less productivity.
This devastating condition afflicts approximately 300 Australians and 60 New Zealanders every year due to traumatic causes. Young males aged between 16-30 years are at greatest risk with the main cause of injury being motor vehicle accidents, followed by falls, sporting or recreational accidents and occasionally, violence.
The number of SCIs as a result of vascular incidents, spinal infections, demyelinating diseases and cancer is estimated to be almost double that of traumatic injury.
Every day another young person has a spinal cord injury
The severity of a spinal cord injury is dictated by the location of the injury along the spine, as well as the extent (or completeness) of permanent damage done to delicate nerve tissues within the spinal cord. Over half of all spinal cord lesions involve trauma in the neck region causing paralysis to all four limbs (tetraplegia, commonly referred to as quadriplegia). Injury to the spine below the neck results in paraplegia, which affects movement and sensation of the trunk and / or the lower limbs.
Improving outcomes
Evidence shows patients with an “incomplete” lesion (and presence of some preserved function) of the spinal cord are experiencing improved outcomes - attributed to rapid patient transfer to specialised trauma centres; intensive medical care, and early surgery to decompress and stabilise the spinal column. Early intervention aims to reduce secondary neural damage (related to swelling, inflammation, impaired blood supply and release of harmful chemicals).
The central nervous system has the ability to change and adapt (referred to as ''plasticity'). Nerves attempt to form new connections or reconnect to acquire alternative pathways for sensory perception or motor skills. However, physical barriers such as cystic degeneration and scar tissue, as well as various inhibitory factors, often prevent regeneration. Most nerve cells that fail to reach their targets for reconnection die and, currently, cannot be replaced. Plasticity can also occur in surviving intact tissue as long as it can be protected from secondary damage.
Some rehabilitation strategies can strengthen existing nerve connections and tap into underlying patterned reflex activity existing within the spinal cord, as well as giving broader health and fitness benefits.
Seeking a “cure”
Promising animal research and pre-clinical reports into therapies that will enhance the recovery of spinal cord damage are prompting investigators throughout the world to plan for clinical trials in the near future.
Strategies being investigated include:
- neuroprotection (ways to prevent secondary tissue loss and maintain function)
- repair and regeneration of damaged nerve pathways
- enhancing plasticity (rewiring) within surviving circuits and pathways
- replacing or assisting function and independence.
International research into spinal cord injury has advanced significantly in recent years. Join ANZSCIN today and work with us to accelerate the investigations and expedite translation of effective treatments from clinical trials into practice throughout Australia and New Zealand.
