Paralyzed Man Walks With Help After New Treatment

A paralyzed man was able to walk with some assistance after doctors transplanted cells from his nasal cavity into his spinal cord.

The patient, a Bulgarian man who was paralyzed from the chest down after a knife attack severed his spinal cord, showed only modest improvement, and experts cautioned that similar procedures have been tried for decades with mixed success. Animal trials have gone both ways.

But in a study published Monday in the journal Cell Transplantation, doctors in Poland and scientists in Britain describe transplanting olfactory ensheathing cells (OECs) into the patient’s spinal cord and constructing a “nerve bridge” between two stumps of the damaged spinal column. The patient moved his limbs a little without help and sensation and even walked with the help of short braces, holding himself with his arms on parallel bars. The procedure was filmed for the BBC program “Panorama.”

OECs act as pathway cells that enable nerve fibres in the olfactory system to be continually renewed.

In the first of two operations, surgeons removed one of the patient’s olfactory bulbs and grew the cells in culture. Two weeks later they transplanted the OECs into the spinal cord, which had been cut through in a 2010 knife attack apart from a thin strip of scar tissue on the right. They had just a drop of material to work with – about 500,000 cells.

About 100 micro-injections of OECs were made above and below the injury.

Four thin strips of nerve tissue were taken from the patient’s ankle and placed across an 8 mm (0.3 in) gap on the left side of the cord.

The scientists believe the OECs provided a pathway to enable fibres above and below the injury to reconnect, using the nerve grafts to bridge the gap in the cord.

Brian Kwon, M.D., a spine surgeon at the University of British Columbia who was not involved with the research, said he was cautiously excited because it was a small study that found only modest improvements. “Any type of improvement is important, and our field will move forward with this type of research, even if it is a small improvement,” Kwon said.

He and other experts suggested more research is needed to evaluate the promise of the technique. “In fact, there is no evidence that the transplant is responsible for the reported neurological improvement,” said Simone Di Giovanni, M.D., Ph.D., chair in Restorative Neuroscience at Imperial College in London, United Kingdom.