Spinal cord injury: promising interventions and realistic goals

Am J Phys Med Rehabil. 2003 Oct;82(10 Suppl):S38-49. doi: 10.1097/01.PHM.0000086994.53716.17.

Abstract

Long regarded as impossible, spinal cord repair is approaching the realm of reality as efforts to bridge the gap between bench and bedside point to novel approaches to treatment. It is important to recognize that the research playing field is rapidly changing and that new mechanisms of resource development are required to effectively make the transition from basic science discoveries to effective clinical treatments. This article reviews recent laboratory studies and phase 1 clinical trials in neural and nonneural cell transplantation, stressing that the transition from basic science to clinical applications requires a parallel rather than serial approach, with continuous, two-way feedback to most efficiently translate basic science findings, through evaluation and optimization, to clinical treatments. An example of mobilizing endogenous stem cells for repair is reviewed, with emphasis on the rapid application of basic science to clinical therapy. Successful and efficient transition from basic science to clinical applications requires (1) a parallel rather than a serial approach; (2) development of centers that integrate three spheres of science, translational, transitional, and clinical trials; and (3) development of novel resources to fund the most critically limited step of transitional to clinical trials.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Animals
  • Clinical Trials as Topic / methods
  • Electric Stimulation Therapy / instrumentation
  • Electric Stimulation Therapy / methods
  • Humans
  • Nerve Regeneration / physiology
  • Paralysis / etiology
  • Paralysis / rehabilitation
  • Rats
  • Recovery of Function
  • Spinal Cord Injuries / complications
  • Spinal Cord Injuries / physiopathology
  • Spinal Cord Injuries / rehabilitation*
  • Spinal Cord Injuries / surgery
  • Stem Cell Transplantation / methods
  • Treatment Outcome