Friday, November 06, 2009

Research Tackles Scar Tissue Formation in Spinal Cord Injuries

Today on Slashdot there is a story about some research that has found a way to mitigate spinal cord scar tissue formation if not actually remove it after it has formed. The approach is to use a stabilized enzyme that helps remove the scar tissue. The Reuters story also mentions that this is but one small piece of the complicated puzzle which is trying to repair spinal cord injury. Many other advances have to happen for repair to be viable, but this discovery is a step in the right direction.

Tuesday, June 16, 2009

Great article on cord tethering...

The term "tethered cord" is overloaded with two meanings. This is article about spinal cords which have scar tissue (or adhesive arachnoiditis) attaching them to the dura at any level, not about the controversial "occult tight filum terminale" tethered cord.

This article, Untethering the Invisible Knot, follows a group of patients with varying degrees of partial paralysis as they try cord detethering sugery to try to preserve or restore neurologic function.

What I like about this article is the stories of strong people who are living with spinal cord injuries (SCI). I also like the realistic reports of surgical outcomes. I feel like most neurosurgeons have a excessively optimistic view of their outcomes, which is reflected in the very positive statistics they report. When you talk to patients, you get a different view of surgical outcomes.

I believe any intradural spine surgery is very risky, and that the scarring and inflammation caused by the surgery often negate any initially positive results.

If I may get on the soapbox for a moment, I'd like to urge neurosurgeons to be more scientific about their outcomes. Having a neutral third party doing pre- and post-surgical assessments would yield a more accurate picture of true patient outcomes. I know this is easier said than done but I've found the current set of outcome data presented by neurosurgeons to be, at times, significantly optimistic.