Most people are shocked to learn that an estimated 500 million people around the world are disabled.The physical, economic, social and psychological impact of disability is shared by the affected individuals, their families, friends, communities and society at large.

The United Nations Programme for Action for Persons with Disabilities calls for global acceptance, equality and justice for all people with disabilities. The reality in many poorer countries, however, is an appalling record of human rights abuses and often those most marginalized and neglected are people with disabilities.

Spinal cord injury (SCI) is one of the most devastating disabilities and affects mostly young, physically active people between 18 and 28. Depending on the severity of the paralysis, a person may regain all, part or very little of their bodily functions. The severe physical and psychological affects of spinal cord injury can inhibit personal independence and make it very difficult for an injured person to reintegrate into their community and become a fully contributing member of society.

Spinal Cord Injury Facts

Latest Research

In recent years, new hope has developed that one day spinal cord injuries will be cured. Scientists from around the world have discovered some of the factors inhibiting  regeneration in the spinal cord. Preliminary experiments on rodents and animals have been successful in returning function to previously paralyzed limbs. It is only a matter of time and money before we see successful application of these experiments on humans with spinal cord injuries.

The following is courtesy of Dr. Dan Deforge, M.D. FRCPC

The topic of spinal cord research is broad, and often mistaken to be only related to the concept of paralysis cure exclusive of care. Although it is reasonable and desirable to work towards Spinal Cord Regeneration, which I believe is attainable, we must also continue to study ways of optimizing physiological, anatomical, rehabilitative, psychological and spiritual adaptations of this devastating process. The current health of individuals with SCI encompasses all these spheres and must remain a priority. This will not only prevent their deterioration but will also optimize the effectiveness of any new spinal cord repair strategies that are introduced. Therefore, three broad categories for SCI research can be defined; prevention, care and cure.

Spinal cord injuries present two immense challenges:

• to limit traumatic nerve destruction and its aftermath,
• and to restore movement and sensation to the injured person

In both cases, a combination of therapies will likely be needed. Our nervous system contains chemicals called neurotrophins. Many laboratories continue to investigate neurotrophins, naturally occurring proteins that nurture nerve cells. To their surprise, the researchers discovered that the production of some neurotrophins and their receptors continues and may even increase for up to six weeks after an injury. Neurotrophins also have a dark side because they can kill neurons under certain circumstances. Additional studies should reveal how best to use neurotrophins therapeutically.

Scientists have found that the immune system response to spinal cord injury is both pervasive and prolonged. Laboratories showed that the complement cascade, the first wave of the immune reaction, begins within 24 hours of an injury and floods the cord with toxic molecules. Blocking these molecules from binding to axons might preserve nerve tracts.

Molecules in the extracellular matrix, the material that surrounds cells, contain guidance molecules that direct developing axons where to go. Some guidance molecules are produced following a spinal cord injury. Yet scientists do not know what role the molecules play in the injury scenario. These molecules might be harnessed to promote nerve regeneration.

Bridging a spinal cord lesion will require nerve regeneration or nerve replacement or, in some cases, both interventions. Several groups have made exciting progress in these areas. A new regeneration strategy uses ensheathing glia of nasal epithelium, myelin-producing cells from the lining of the nose. Scientist continue to explore methods to overcome the elements of myelin that normally stop regenerating axons from entering the white matter, the outer part of the spinal cord, constituted of mostly axons.

Several years ago, the field of regeneration received a sudden boost of hope. Lars Olson of the Karolinska Institute reported for the first time having achieved "true functional recovery" of a severed adult rat spinal cord. Olson and colleagues used a five-step strategy, including implanted peripheral nerve bridges stabilized by using fibrin glue mixed with fibroblast growth factor. Scientists caution that the procedure was successfully done on only a few animals and none recovered the ability to walk. These experiments will have to be replicated in other laboratories around the world, and these various strategies will likely have to be combined in animals, before human trials begin.

Dan Deforge, M.D. FRCPC