Biomedical Engineering and the Future of Spinal Cord Injuries
"I broke my spine in a car accident on April 16, 1985, 25 years and four days ago. Since then I cannot walk, nor have I felt in my body the fresh torrent of rivers or the churning surf of the sea. My arms are my motor as I enjoy a spin around the Parque Mexico park. I speed up to the maximum until my spastic legs shake, burn and tingle. Then I relax and it feels like I was standing and they were carrying me ..."
Saúl López de la Torre, Author
Spinal Cord injuries are a complex issue for modern medicine, for friends and family of the patient, and of course, for the patient themselves. Recent scientific research has focused on finding solutions integrating technology, biology and medicine. Today there is light at the end of the tunnel for those who suffer of these lesions.
Most leading scientists are focused on restoration of neurological connections between the brain and the body of the person with a spinal cord injury. Bioengineers are working to restore functional connections via advanced computer models and neural prostheses. The integration of artificial limbs to paralyzed bodies requires both electrical technology and neurobiology. FES or Functional Electrical Stimulation is an example of this new area of investigation.
The FES system uses electrical stimulators to control the muscles of the legs and arms, with the aim of promoting functional walking and to reach and grasp objects. Electrodes are attached to the skin at the level of the nerves or surgically implanted and are controlled by a computerized system that receives user commands. For example, to help someone to grasp an object, electrodes could be placed in the shoulder and upper arm and controlled by movements of the other shoulder. By using a computerized connection, a person with a spinal cord injury can trigger movements in the arm to extend or retract the opposite shoulder.
Because the brain plans voluntary movements several seconds before sending the order to the muscles, people whose spinal cords no longer carries the signals to their extremities can still complete the planning phase in their brains, then use a robotic device to execute the command. A recent experiment used micro wires implanted in the area of the motor cortex of the brain (in this case the brain of a monkey) to record brain wave activity, which was then relayed to a computer that analyzed the data and predicted the motion, which in turn sent a command to the robotic arm. Such a device could theoretically be used to control a wheelchair, a prosthesis, or the arms and legs of the patient themselves.
In the future, this kind of brain-machine interfaces could be placed directly into the brain using miniature electronic devices (microchips) that would process the information and transmit the results wirelessly. Currently, there are experiments with hybrid neural connections, which are implantable electronic devices in the body that have a biological component that stimulates cells to integrate into the host nervous system.
It seems like science fiction; biosensors, new materials for grafting, more targeted drugs and other advances that are being studied in many biomedical engineering laboratories worldwide.
The goal of the National Cancer Institute of the United States is to use bioengineering to eliminate the suffering and death caused by cancer. Current research focuses on how to use it to radically change the ability of medicine to diagnose, understand and treat cancer, also, the NASA boosts programs to design a prototype artificial cell that can replace the damaged cell of the central nervous system to heal the injury.
Bioengineering thus becomes a fundamental branch of the promising applications of science, probably one of the most important for human beings; however all developments should be taken with cautious optimism, as none of the experiments have been carried out in humans.
What should we do now?
Unfortunately, injuries and spinal disease pose the risk drastic consequences if appropriate care is not delivered immediately. We should all be aware of the importance of prevention. Bedsores, scoliosis and dyspnea related to spinal cord injuries are preventable if we use currently available technology.
The standing position can be appropriate treatment. Many varieties of cushions are available to improve posture and prevent decubitus ulcers.
If we want to give patients hope for a better life tomorrow we must act now and not let secondary disease affect them. In many cases, prevention is relatively simple. We have all the technology and techniques at hand. For a brighter future, the key is to act now.
Ernesto Estrada Mondaca
Sales Manager Southern Cone
Bibliography:
Robin Latham, Office of Communications and Public Liaison, NINDS
“Spinal cord injury: a hope to research opens”, 2005, NINDS
http://www.solociencia.com/medicina/08052604.htm(link is external)
http://www.nexos.com.mx/?p=13705(link is external)
More information:
http://www.ninds.nih.gov(link is external)
http://www.christopherreeve.org(link is external)
http://www.themiamiproject.org(link is external)
http://www.pva.org(link is external)
http://www.spinalcord.org(link is external)
http://www.naric.com(link is external)
http://scsus.org/(link is external)
http://www.proyectolazarus.com/proyecto/(link is external)
