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Trending science: Paralysed man walks again after stem cell transplant

In a world first, a man paralysed due to a spinal cord injury is able to walk again, thanks to stem cell surgery.

Darek Fidyka, a Bulgarian fireman, was injured in a knife attack in 2010, which left him paralysed from the chest down. He has received pioneering surgery which involved transplanting cells from his nose into his spinal cord in the first practical application of stem cell surgery of this kind. Professor Geoffrey Raisman, whose team at University College London’s institute of neurology discovered the technique, told the Guardian: 'We believe that this procedure is the breakthrough which, as it is further developed, will result in a historic change in the currently hopeless outlook for people disabled by spinal cord injury.' Before the surgery Mr Fidyka had been paralysed for over two years and showed no signs of regaining sensation despite intensive physiotherapy. He described walking again – with the support of a frame – as 'an incredible feeling', adding: 'When you can't feel almost half your body, you are helpless, but when it starts coming back it's like you were born again.' The treatment, the first of its type, was carried out by surgeons in Poland in collaboration with scientists in London who have been working in the field for decades. It involved removing one of Mr Fidyka’s two olfactory bulbs, one found at the top of each nostril. These contain olfactory ensheathing cells (OECs) which form part of our sense of smell. What makes these of special significance to the treatment is their function as pathway cells which enable the olfactory system to be continually renewed. They are the only type of nerve cell known to regenerate. In the first of two procedures, scientists extracted the olfactory bulb, growing the OECs in a culture. This resulted in the creation of a drop of material containing around 500 000 cells. Two weeks later, surgeons made around 100 micro injections above and below the site of the injury in Mr Fidyka’s spinal cord. They used four thin strips of nerve tissue from his ankle, placing them across the 8mm gap in the left hand side of the patient’s spinal cord to act as a bridge. After three months Mr Fidyka’s left thigh began to put on muscle, six months after the surgery he was able to take his first, cautious step, using parallel bars and leg braces. Two years on, and after exercising five hours a day, five days a week, Mr Fidyka can now walk outside the rehabilitation centre using a frame. The team believe that the OECs have provided a pathway, enabling fibres above and below the injury to connect to the nerve graft bridge. They see the patient’s recovery as evidence of regeneration and MRI scans suggest the gap has closed up since treatment. In an interview with the BBC, Dr Pawel Tabakow, consultant neurosurgeon at Wroclaw University Hospital, who led the Polish research team, said: 'It's amazing to see how regeneration of the spinal cord, something that was thought impossible for many years, is becoming a reality.' The scientists hope to treat another 10 patients, probably those whose spinal cords have been severed cleanly. Sir Richard Sykes, chair of the UK Stem Cell Foundation told the BBC that developing future treatments to benefit the 3 million people paralysed globally will need continued investment for the necessary wide-scale clinical trials. For further information please visit: http://www.ingentaconnect.com/content/cog/ct/pre-prints/content-CT-1239_Tabakow_et_al

Countries

Poland, United Kingdom

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