Contusive Spinal Cord Injury

Contusive Spinal Cord Injury
Contusive Spinal Cord Injury

When we think about our ability to control and move our limbs, to grasp and lift objects, or to simply walk from one place to another, our muscles and bones come to mind first. That’s natural. However, none of that would be possible without your spinal cord – a part of the central nervous system running from the base of the brain to about mid of your spine and then continuing as a bundle of nerves all the way to your tailbone.

It is this bundle of nerves that is responsible for carrying messages from the brain to the various muscle groups in the body. Without it, you could not raise a coffee cup for a sip, nor could you take a single step. Because of its central importance to our lives, the spinal cord is well protected within the spine itself. It is encased in a sheath of tissue, and that sheath is routed through the bones of the spine itself.

However, despite that protection, spinal cord injuries can and do happen, and they occur with startling frequency. In fact, the American Association of Neurological Surgeons estimates that there may be as many as 450,000 people in the US currently living with some type of spinal cord injury, and another 11,000 to 12,000 injuries occur every single year.

There are two types of spinal cord injury – complete, or trunsection of the spinal cord, and incomplete, or contusions of the spinal cord (basically a bruise of the cord). Complete injury means that you have no motor control below the injury, nor do you have any sensory function below that point. These are usually called transection of the spinal cord. However, contusions of the spinal cord allow at least some sensory function and motor control below the point of injury.

What Is a Spinal Cord Contusion?

According to a study published in the journal Neural Regeneration Research in 2014, a spinal contusion is,

"an injury caused by crushing of the cord with part of its tissue spared, particularly the ventral (underside) nerve fibers connecting the spinal cord rostral (above) and caudal (below) to the injury remain physically intact. The severity of the spinal cord contusion is mainly judged by the physiological status of the remaining nerve fibers, whether the action potentials can pass through smoothly, are hampered, or are totally lost.

The American Association of Neurological Surgeons explains further. Spinal cord contusions “may produce neurological symptoms including numbness, tingling, electric shock-like sensations and burning in the extremities. Fracture-dislocations with ligamentous tears may be present in this syndrome."

So, in a nutshell, a spinal cord contusion is a crushing injury to the spine in which some or most of the tissue remains undamaged, and you may have at least some motor control and sensory function below the injury. These injuries can cause partial loss of motor control and physical sensation, but as noted above, they can also cause a wide range of other symptoms.

Who Is at Risk for a Spinal Cord Contusion?

It is important to understand that spinal cord injuries, including spinal contusions, can affect anyone, of any age, at any time. They are common in many different types of accidents in which physical impact is a major component – slip and fall injuries on hard surfaces, auto accidents, and the like. However, there are certain demographics and activities where there is a much greater chance of spinal contusion or more serious spinal injuries occurring.

Spinal injuries in general are more common in men than in women, and are most common in males aged 16 to 30. Almost 90% of spinal injuries are sports related, as well, with football being the most common sport in which these injuries occur. However, for older adults, the most common cause of a spinal cord injury is being involved in an auto accident, followed by falls, and then gunshots.

What Treatment Options Exist?

Spinal cord contusions, while painful and debilitating, are the most easily recovered from type of spine injuries. Those with transactions often face total loss of movement and sensation below the injury even with immediate medical care. Those with transactions higher up the spine often face death. For instance, a transection between cervical levels C2 and C3 usually results in death, while a transaction from C4 through T1 (thoracic) results in quadriplegia (paralysis in both arms and legs). T1 trough L5 (lumbar) injuries often result in paraplegia (legs paralysis).

With a spinal cord contusion, there are several potential treatment options that can ease pain and discomfort and alleviate associated neurological symptoms. Bed rest and medication can play a role, but surgery may be necessary depending on the amount of damage, including debridement of any necrotic tissue resulting from the injury. Depending on the severity of the contusion, physical therapy may be necessary.

How Can Stem Cells Help Treat Spinal Cord Contusions?

Stem cell therapy shows immense promise for treating an incredibly wide range of diseases and injury types, including spinal cord contusions. A great deal of research is currently ongoing using stem cells to treat various degrees of spinal cord injury.

According to a study published in the journal Cell,

"the use of mesenchymal stem cells may be a promising therapeutic strategy for immunomodulation and trophic support in SCI (spinal cord injuries). Embryonic stem cells, neural stem cells, induced pluripotent stem cells, olfactory ensheathing cells, and Schwann cells can contribute to replacing spinal cord architecture and functionality. The association of stem cells and biopolymer support may provide localized targeted therapy to maximize the efficacy of cell treatments in SCI."

Another study, this one focused specifically on treating contusive spinal cord injury and published in 2010, indicates that

"transplantation of mesenchymal stem cells (MSCs) derived from bone marrow has been shown to improve functional outcome in spinal cord injury (SCI). Systemic delivery of MSCs results in therapeutic benefits in a number of experimental nerves system disorders."

It should be noted that both studies mentioned above relied on autologous stem cells derived from adult human tissue. These cells have limited healing capabilities, and due to the level of mutations sustained over time, may trigger a negative immune system response. Instead, allogeneic stem cells sourced from umbilical cord blood and tissue (pluripotent stem cells) offer improved healing and are invisible to the immune system. Most importantly they are significantly more potent and long-lasting.

In the end

Treating contusive spinal injuries may be simplified by using stem cell therapy. However, there is currently no FDA-approved stem cell treatment available, and any such treatment option should be considered experimental.

Source:

https://www.ncbi.nlm.nih.gov/pubmed/20470759
https://www.ncbi.nlm.nih.gov/pubmed/19555980
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270592/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467343/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4292327/
https://www.cell.com/trends/molecular-medicine/fulltext/S1471-4914(17)30123-5
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146247/
https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Spinal-Cord-Injury
https://www.hopkinsmedicine.org/healthlibrary/conditions/physical_medicine_and_rehabilitation/spinal_cord_injury_85,p01180

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