Spinal scaffold technique heralds new dawn in spinal injury treatment

New data has revealed there are an estimated 50,000 people in the UK living with spinal cord injuries (SCI) and each year approximately 2,500 people are newly injured. Research carried out by the Spinal Injuries Association (SIA), Aspire and Back-up (three of the leading UK charities providing support to people with spinal injuries) has shown that numbers of people living with spinal injuries are much higher than was previously thought.

For those affected by spinal injury, the consequences can be life-changing, often resulting in mild to severe paraplegia, bladder dysfunction, sexual dysfunction, and/or spasticity. As well as physical and emotional costs to the individual affected and their loved ones, the fallout of dealing with spinal injury carries significant financial impacts to parts of our economy. From the millions of pounds paid out in spinal injury claims for compensation, through to the huge cost borne by the National Health Service (NHS), with the National Institute for Health and Care Excellence (NICE) forecasting an estimated lifetime cost of £2.5 million per patient.

Sarah Bryan, Chief Executive of Aspire said: “The new statistics show that there are over twice as many people out there who need our help – people who may have never received specialist support at a spinal centre and have no idea where to turn for help”.

Despite the astronomical costs of caring for patients with SCI, unfortunately, there is currently little that doctors can do to help patients regain lost functions. But a new study, carried out by researchers at the University of California, Los Angeles (UCLA), offers renewed cause for optimism, with the prospect of injections of porous scaffold material helping facilitate the body’s natural healing process.

The human body is inherently good at repairing injuries, but it struggles with some of the most critical ones. Axons, the nerve fibres that transmit electrical impulses around the body, are unable to regenerate following injury, a key factor in what can make spinal cord injuries so debilitating. One of the primary issues is caused by immune cells flooding to the site after the injury. Whilst a certain level of immune response is essential to promote wound healing, an overactive response in the acute phase of Spinal Cord Injuries and persistence of these inflammatory cells in the chronic phase cause the formation of dense scar tissue. While some degree of scar formation can prevent the injury from spreading and helps in limiting further cell death, several components of this scar tissue likely inhibit the ability of regenerating axons to bridge SCI lesions.

In UCLA’s most recent research, the team focused on helping facilitate the regeneration of axons by creating an environment that supported cells and encouraged the repair of connections. To achieve this, the team at UCLA have developed scaffold materials that closely mimic the natural spinal cord tissue. Made from hyaluronic acid, a major structural and bioactive component of the spinal cord extracellular matrix, the newly developed biomaterial is highly porous, providing a porous support structure the cells can migrate into to facilitate healing. In addition to its porous structure, the scaffold material is loaded with gene therapy vectors. These vectors encode for a molecule called brain-derived neurotrophic factor (BDNF), which helps the axons survive longer and promotes regeneration.

Stephanie Seidlits, an author of the study said:

“In this study, we demonstrate that incorporating a regular network of pores throughout these materials, where pores are sized similarly to normal cells, increases infiltration of cells from spinal cord tissue into the material implant and improves regeneration of nerves throughout the injured area”.

Although only in its early stages and not yet tested on human subjects, the research demonstrates how the introduction of a porous support structure improves the efficiency of gene therapies administered locally to the injured tissues. Since a significant number of spinal cord injuries result from a contusion, it is imperative that the biomaterial implants are able to be injected in or near the injured area without causing damage to any unaffected tissue surrounding the injury. A major technical challenge has been developing scaffold materials with macroporous architectures that are also injectable.

Other studies into the treatment of spinal cord injuries, such as injecting stem cells, or the molecules expressed by them, into the injury sites have also offered promising results, whilst other potential treatments offer the possibility of activating restorative gene therapy by administering an “on switch” drug.

Dawn Humphries, head of personal injury at Lanyon Bowdler said:

“With over 2,500 people being newly affected by spinal injuries in the UK each year, the development of new treatment techniques is an essential area of medical research and offers significant hope for an improved quality of life for those affected in the future”.

Lanyon Bowdler solicitors in Shrewsbury are members of the SIA (Spinal Injuries Association), the firm also hosted the 2018 ‘Spinal Injury Conference – The Journey’ event in Shropshire, see: https://youtu.be/LT4ssB4_zew. As a UK top 200 law firm, Lanyon Bowdler are nationally recognised for their expertise surrounding spinal injury.