Advancing Spinal Cord Injury Treatments

MURRAY, UT (1/20/2010) ─ While treatments have improved for spinal cord injuries over the past decade, trauma researchers at Intermountain Medical Center in Utah and James J. Peters VA Medical Center in the Bronx, New York, are working to find out if medical providers could be doing more to improve their patients’ outcomes through a new, unique study focusing on changes in patients’ organ systems that occur immediately after the injury.

“We’re conducting a study that’s unique, because little is known about organ system changes immediately after a spinal cord injury, called the acute phase, nor is there much research into the evolution of these abnormalities and the pathophysiology that underlies them. There are many studies about the rehabilitation phase, but not the initial acute phase,” says Mark H. Stevens, MD, medical director of trauma services at Intermountain Medical Center. “This glaring gap in our knowledge limits our ability to effectively plan treatments that could enhance our patients’ rehabilitation after a spinal cord injury.”

The research teams at the two centers hope to enroll spinal cord injury patients who would be studied for up to two years to determine the impact of spinal cord injuries on their organ systems. During that period, researchers will be taking blood, performing muscle biopsies, and using an array of sophisticated monitoring equipment.

Among the questions they will be asking:

• How are anabolic, stress, and sex hormone levels affected?
• How much will fat and muscle mass change?
• How is respiratory muscle strength affected?
• How much will diaphragm thickness change?
• How much will heart rates and circulation vary?

According to Dr. Stevens, this is only the first step in a series of studies, which will likely result in new interventions that will be tested and become new best practices for treating spinal cord injury patients nationwide.

“We’ll also need to evaluate the timing of those interventions to best serve future patients. Any changes in the magnitude of deterioration of body systems can provide a better quality of life for patients and perhaps lengthen their lives,” he says.

According to the Christopher and Dana Reeve Foundation, over 1.2 million people have reported being paralyzed due to a spinal cord injury. Approximately 52 percent are considered paraplegic and 47 percent are quadriplegic. Fifty-six percent of spinal cord injuries occur between the ages of 16 and 30. The average age for a spinal cord injury is 31 years old, according to the Spinal Cord Injury Facts website.

“We have lots of questions that need to be answered,” says Jolene Fox, RN, senior researcher for trauma services at Intermountain Medical Center. “Our colleagues at James J. Peters VA Medical Center have done some of the premiere work. However, they’ve only had access to patients once they reached the rehabilitation phase of care, not the initial acute phase. Our research is badly needed so all of their rehabilitation research can be put into the proper context.”

Fox says the reason there haven’t been more extensive acute injury studies is that it can be difficult to recruit patients within 72 hours of their spinal cord injury.

“This is a very traumatic time for someone who may become paralyzed — it’s very difficult for both the patient and the family,” says Fox. “Fortunately, here in Utah, we have a culture of cooperation and helping each other. This study will require a large number of tests and a strict schedule. That’s why we have a clinical coordinator on our team, whose sole purpose is to provide the one-on-one personal attention each of our patients will need and should have to help them get through this process.”

Dr. Stevens says the next step after this study will involve evaluating interventions for specific body systems.

“We’ll also need to evaluate the timing of those interventions to best serve future patients. Any changes in the magnitude of deterioration of body systems can provide a better quality of life for patients and perhaps lengthen their lives,” he says.