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 The technique, described as a breakthrough by a study in the journal
Cell Transplantation, involved transplanting what are known as
olfactory ensheathing cells into the patient's spinal cord and
constructing a "nerve bridge" between two stumps of the damaged
spinal column.
"We believe... this procedure is the breakthrough which, as it is
further developed, will result in a historic change in the currently
hopeless outlook for people disabled by spinal cord injury," said
Geoffrey Raisman, a professor at University College London's (UCL)
institute of neurology, who led the research.
The 38-year-old patient, Darek Fidyka, was paralyzed after suffering
stab wounds to his back in 2010. Following 19 months of treatment,
he has recovered some voluntary movement and some sensation in his
legs, his medics said.
The Nicholls Spinal Injury Foundation, a British-based charity which
part-funded the research, said in statement that Fidyka was
continuing to improve more than predicted, and was now able to drive
and live more independently.
Raisman, a UCL spinal injury specialist, worked with surgeons at
Wroclaw University Hospital in Poland to remove one of Fidyka's
olfactory bulbs, which give people their sense of smell, and
transplant his olfactory ensheathing cells (OECs) and olfactory
nerve fibroblasts (ONFs) into the damaged area.
They used a nerve bridge constructed between the two stumps of the
damage spinal column, they said in the study.
OECs are a type of cell found in both the peripheral and central
nervous system. Together with ONFs, they make bundles of nerve
fibers that run from the nasal mucosa to the olfactory bulb, where
the sense of smell is located.
When the nerve fibers that carry smell become damaged, they are
replaced by new nerve fibers which re-enter the olfactory bulbs, the
researchers explained in their study.
OECs help this process by re-opening the surface of the bulbs for
the new nerve fibers to enter -- leading Raisman and his team to
believe transplanting OECs into the damaged spinal cord could enable
severed nerve fibers to re-grow.
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Raisman added that the technique of bridging the spinal cord with
nerve grafts from the patient had been used in animal studies for
years, but never before in combination with OECs.
"The OECs and the ONFs appeared to work together, but the mechanism
between their interaction is still unclear," he said in a statement
about the work.
Experts not directly involved in the work said its results offered
some new hope, but said more work needed to be done to figure out
what had led to this success, and more patients treated, before its
potential could be properly assessed.
"While this study is only in one patient, it provides hope of a
possible treatment for restoration of some function in individuals
with complete spinal cord injury," said John Sladek, a professor of
neurology and pediatrics at the University of Colorado School of
Medicine in the United States.
Raisman and his team now plan to repeat the treatment technique in
between three and five patients over the next three to five years.
"This will enable a gradual optimization of the procedures," he told
Reuters.
(Reporting by Kate Kelland, editing by Crispian Balmer)
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