Radiation Therapy Combined with Microsurgery Shows Potential for Curing Damaged Spinal Cord

Since repair of damaged cord directly correlates with prevention of paralysis, this research demonstrates that conventional clinical procedures hold promise for preventing paralysis from spinal cord injuries.

Currently there is no cure for human spinal cord injury. Treatment after injury is largely limited to steroids administered to prevent further deterioration. "This research opens the door to developing a clinical protocol for curing human spinal cord injuries using conventional therapies,” said lead researcher Nurit Kalderon, Ph.D., from Sloan-Kettering Institute for Cancer Research (New York, NY, USA).

In the current research, the scientists made a severe crush injury, similar to a human contusion/fracture injury, in spinal cord of adult rats just below the waist. In crush injuries, tissue decay is exacerbated by the secondary damage caused by massive swelling as fluids build up from the injured blood vessels. When the investigators administered radiation alone, there was no detectable beneficial effect on the body's repair of the crushed cord. However, the researchers recalled findings from nearly 100 years ago showing that incision at the damage site along the midline of the cord (myelotomy) could drain the accumulated fluids and reduce tissue damage.

Dr. Kalderon and her colleagues at Sloan-Kettering then made longitudinal micro-incisions down the center of the injured cord within the first 24 hours after injury to release the fluid buildup. There was significant reduction in the size of lesion site, confirming the earlier research. They then combined the radiation treatment with the microsurgery.

The investigators were able to show the improvements in wound healing both by post-mortem examination of the tissue three months after injury, as well as magnetic resonance imaging (MRI) on the living rats. This indicates that the effectiveness of these therapies on humans could also be assessed using MRI technology.

The researchers also evaluated a third level of treatment. Recognizing that exercise may increase tissue repair, they added 10 minutes of treadmill exercise five days a week to the radiation therapy, starting at the second week after injury. Once more, the spinal cord ability to repair itself was noticeably improved. Rats treated with incisions to reduce the harmful fluid accumulation, followed by radiation therapy at the site to remove damaging cells and regular treadmill exercise saw a three-fold improvement in the body's ability to repair the severely crushed cord, going from 19% of cord tissue that was healthy in untreated rats to 56.3% of cord tissue that was repaired and saved from further damage.


Related Links:
Sloan-Kettering Institute for Cancer Research