Affiliations: Department of Anatomy and Structural Biology, University of Otago, Dunedin, New Zealand
Correspondence:
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Address for correspondence: D. Gareth Jones, Department of Anatomy and Structural Biology, University of Otago, PO Box 913, Dunedin, New Zealand. Tel.: +64 3 479 7364; Fax: +64 3 479 7254; E-mail: gareth.jones@stonebow.otago.ac.nz
Note: [1] This is an adaptation of a lecture given by Professor Jones to
the Australasian Branch of the International Spinal Cord Society,
Auckland, New Zealand, 30 November 2002.
Abstract: The failure of the adult human spinal cord to regenerate following injury is not absolute, but appears to be amenable to therapeutic manipulation. Recent work has shown that the provision of a growth permissive environment by the neutralization of inhibitory influences, or the grafting of fetal tissue, peripheral nerve, Schwann cells, or olfactory ensheathing cells can enhance regeneration in animal models of spinal cord injury. Stem cells are gaining ever-increasing favour as a treatment option for spinal cord injury. The potential of neural stem cells, embryonic stem cells, and bone marrow stromal cells is discussed. Additional treatment options such as pharmacological interventions, functional electrical stimulation and physiotherapy approaches are also explored. Basic science insights are used as a foundation for a discussion of a variety of clinical perspectives including repair of the chronically injured spinal cord, animal models of human spinal cord injuries and clinical trials. A more holistic approach towards spinal cord injury is suggested, one where a hierarchy of needs is recognised and quality of life is paramount. Finally, this review cautions against overly grandiose claims of an imminent miracle cure for human spinal cord injury.
