Spine injury is defined as any injury to spine due to trauma. The incidence of Spinal cord injury is estimated to be about 60-80 per million.
The case fatality of acute spinal cord injury is widely varied from 30% to more than 50% depending upon the site and grade of injury. Depending upon the site of injury they can be classified as cervical, dorsal and lumbar. Depending upon the extent of injury they are classified as “ complete” and “incomplete”.
Treatment in Spinal cord injuries is directed at preventing secondary damage due to inflammation and removing bony compression on the cord.
Surgery is spinal injuries is usually directed at stabilizing the spine to prevent further damage and if there is complete injury then to facilitate mobilization and rehabilitation. The spine injury could be complex and the rehabilitation is very prolonged. Till recently the outcome of spinal injury was disastrous. Now with better understanding of spine and better equipments, complex spine stabilizations are being done with ease and there are special rehabilitation centers facilitating better recovery of spinal cord injured patients.
Depending upon the extent and site of injury the stabilization procedures could be extensive. Initially spinal cord injury surgeries involved extensive skin incisions and prolonged hospitalization. Now with advent of minimal invasive techniques the surgeries can be performed with minimal skin incision.
Stem Cell Therapy: Of late world wide there are encouraging reports in laboratory tests that stem cells when injected at the site of injury have been able to restore spinal cord recovery. It is also evident that when stem cells are injected in the area of damage in the spinal cord, they secrete neurotrophic factors, and these neurotrophic factors help neurons and vessels grow, thus helping repair the damage. Bone Marrow Stem cells especially the CD34+ cells have been found to be relatively more in men compared to women in the reproductive age group among spinal cord injury patients.
Other than stem cells, transplantation of tissues such as olfactory ensheathing mucosa have been shown to produce beneficial effects in spinal cord injured rats. Independent validation of the results of the various stem cell treatments is lacking. However, current approaches on cell and tissue based therapies for clinical application for spinal cord injury need to establish the underlying efficacy and mechanisms. In our experience of stem cell injections for various spinal cord injury patients the results have been mixed. Some patients have shown improvement and some have not and its very difficult to quantify the effectiveness and extent of recovery.