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Principles of Sports Medicine & Exercise Science

Advances in Spinal Cord Injury Research

by Liam Hooper

Category: Therapy

Specialties and related fields: Neurology, neurosurgery, orthopedics, regenerative medicine

Definition: a new treatment for severe spinal cord injuries that puts electrical impulses into the spine to restore blocked nerve impulses

KEY TERMS

physical rehabilitation: a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment

spinal cord injury: damage to the tight bundle of cells and nerves that sends and receives signals from the brain to and from the rest of the body

INTRODUCTION

Spinal cord injury (SCI) is a complex condition that affects the entire body. The spinal cord and the brain make up what is known as the central nervous system (CNS). The spinal cord consists of a tight bundle of blood vessels, neural cells (neurons), and the specialized glial cells surrounding neurons, providing support and insulation. The neurons extend their nerve pathways (axons) from the base of the brain to the lower back. The spinal cord network receives information from the rest of the body and relays that information to the brain. The brain also sends messages through the network to all body parts. The network of nerves outside the brain and the spinal cord is known as the “peripheral nervous system.” Damage to the spinal cord disrupts the delicate system of whole-body communication that assures well-being and overall functionality.

The injury occurs when the vertebrae that normally protect the cord’s soft tissue (nerves) break or dislocate in ways that put pressure on the cord. Injury type and location determine likely outcomes. The more axons that remain intact, the greater the chance of function recovery. Loss of function occurs below the point of injury. Therefore, the higher the injury is on the cord, the greater the loss of function.

In a 2019 update, the National Institute of Neurological Disorders and Stroke (NINDS) estimated that 12,000 SCIs occur in the United States annually. More than a quarter of a million people live with an SCI. At least 36.5 percent of SCIs result from motor vehicle accidents (MVAs), and over one quarter are due to falls. Acts of violence, sporting accidents, and other factors make up the remainder of SCIs. Approximately 80 percent of SCI patients are male.

ELECTRICAL STIMULATION OFFERS HOPE AND NEW UNDERSTANDING

For generations, the prevailing attitude toward SCI was that injury to the spine was permanent. The belief has been that once the spine is broken, it cannot be repaired. People who suffered an SCI had little hope of partial recovery, let alone full functional recovery. Research and experimentation are revolutionizing the treatment for SCI.

In a 2018 article for leapsmag, author Karen Weintraub reported that recovery is possible, even years after the injury. According to Weintraub, researchers at the Kentucky Spinal Cord Injury Research Center have discovered that neurons that survive an injury can generate signals and initiate movement. Results at the center also indicate that the traditional practice of waiting to attempt treatment, consigning patients to wheelchairs or beds, is not the best practice. The team in Kentucky combined epidural electrical stimulation with physical rehabilitation. Patients receiving the treatment are standing independently, and many are walking. Others are using limbs they never expected to use again.

Researchers at the center believe that some form of physical therapy and treatment should begin as soon as possible for most SCI patients. The team believes that the electrical stimulation paired with physical therapy effectively kick-starts spinal cord nerve circuits into a functioning state. While the volume of nerve message output is lower after injury, there is reason to believe that stimulation trains neurons to respond to the lower volume. The success of this approach calls for a complete change in thinking about SCI.

DOES THE SPINAL CORD HAVE A BLOOD PRESSURE?

Researchers in Kentucky are not the only SCI specialists to realize prevailing beliefs about SCI are not entirely true. Encouraging research is coming out of Zuckerberg San Francisco General Hospital and Trauma Center, as doctors, there are proving spinal cord function can be recovered. According to a 2018 article for MedicalXpress, author Kathleen Masterson reports that Dr. Sanjay Dhall and colleagues have discovered important new factors in injury and recovery that have prompted a new treatment protocol. Their treatment protocol combines revised ways of evaluating injury with new treatments. Traditionally, evaluating injury included imaging and measuring feeling and movement in a patient’s arms and legs. Dhall based the treatment on indications that the most important factor in SCI is spinal cord blood pressure (BP). Spinal BP is called “spinal cord perfusion.” Because the spinal cord regulates BP throughout the body, injury to the cord affects the body’s ability to maintain adequate BP. The new treatment involves measuring each patient’s blood flow to the spine. Previously, doctors would artificially raise everyone’s BP in the same way across different injuries, ages, and general health. Another aspect of the protocol is moving patients who need surgery into an operating room as soon as possible.

At the time of Masterson’s article, Dr. Dhall’s team had treated ten SCI patients with the new protocol. The results have been so encouraging that the new method has become the standard of care.

Image via iStock/magicmine. [Used under license.]

USING STEM CELLS TO TREAT SCI

The hope of using stem cells to treat SCI was born when stem cell research began. Stem cells can develop into specific cells the body needs. Thus, they are the hope of reparative and regenerative treatments. A 2019 article for the Mayo Clinic News Network suggests the hoped-for day of treating SCI with stem cell therapies has arrived. The article by Susan Lindquist reported the early results of a trial with ten SCI patients in Rochester, Minnesota. The Mayo Clinic team used stem cells from the patient’s fat cells to regenerate spinal nerve cells.

The first patient treated has shown improvement in both sensation and motor function. However, not all the patients in the trial had the same response. Researchers hope the trial will answer important questions about ideal dosage, why patients respond differently to stem cell injections, and whether there are side effects to the treatment. This study is important to ongoing research into the effectiveness of stem cell therapies. In addition, it is especially important to regenerative medicine research. Scientists are learning. And what they are learning has life-changing potential for SCI patients now and in the future.

Citation Types

Type

Format

MLA 9th

Hooper, Liam. "Advances In Spinal Cord Injury Research." Principles of Sports Medicine & Exercise Science, edited by Michael A. Buratovich, Salem Press, 2022. Salem Online, online.salempress.com/articleDetails.do?articleName=POSpKin_0099.

APA 7th

Hooper, L. (2022). Advances in Spinal Cord Injury Research. In M. A. Buratovich (Ed.), Principles of Sports Medicine & Exercise Science. Salem Press. online.salempress.com.

CMOS 17th

Hooper, Liam. "Advances In Spinal Cord Injury Research." Edited by Michael A. Buratovich. Principles of Sports Medicine & Exercise Science. Hackensack: Salem Press, 2022. Accessed September 16, 2025. online.salempress.com.

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