- The Washington Times - Monday, January 5, 2004

NFL Hall of Famer Nick Buoniconti looks like he could handle any situation. The ruggedly built ex-athlete rumbled his way through the record books as a Miami Dolphin and Boston Patriot.

When his son was paralyzed from the neck down because of a football injury in 1985, he felt something new. Helplessness.

Today, thanks to research groups like the Miami Project to Cure Paralysis, an outfit born from his son Marc’s condition, persons with spinal cord injuries have hope. And someday, the more optimistic among the scientific community say, injury sufferers may regain some of their mobility.

Our spinal cords carry messages to and from the brain and the various parts of our bodies through a network of nerve cells called neurons. A spinal cord injury results when the nerves within the cord are damaged, often when a fractured vertebrae crushes them due to a physical trauma.

According to the Miami Project, about 11,000 new spinal cord injuries occur each year in the United States, 80 percent of which happen to men. More than half (55 percent) affect people between the ages of 16 and 30.

Before World War II, a spinal cord injury likely was a death sentence. Complications such as kidney infections or respiratory problems after the accident often couldn’t be overcome.

Mr. Buoniconti’s impromptu crash course in these debilitating injuries began nearly 20 years ago when he received a phone call. His son had dislocated his neck making a tackle playing football for the Citadel and was clinging to life.

The father immediately flew to his son’s bedside. Three hours later, he looked into his son’s eyes and saw him wordlessly ask for help.

“For the first time in my life I couldn’t help him,” Mr. Buoniconti says.

That was the first step in the father and son’s collective effort against spinal cord injuries. Today, Marc Buoniconti, now off a respirator and breathing on his own, works tirelessly toward the Miami Project’s goals, while his father raises funds exclusively for the Miami Project trading in on a lifetime of connections, good will and just plain hustle.

Dalton Dietrich, scientific director of the Miami Project, based at the University of Miami, says clinical trials on humans involving regeneration of nerve tissue likely will begin during our lifetimes.

The trials conducted so far on animals, Mr. Dietrich says, offer promise.

“We have a lot of positive preclinical work showing we can enhance [nerve] regeneration and improve functional recovery in experimental animal models,” he says. “To move into people we need to show the therapy’s going to be safe.”

One method supplying a modicum of hope for tomorrow’s spinal cord patient is hypothermia.

“We’re finding out if we bring the temperature of the spinal cord or the brain down a couple of degrees [in the hours after an accident] we get some significant improvement in function,” says Mr. Dietrich, who adds the technique is practiced in some stroke patients and may soon be done with spinal cord injuries. The lower temperature reduces swelling that occurs following trauma, a reaction that can put pressure on the nerve cord.

An exciting research frontier involves repairing the damaged nervous system.

“We can take helper cells, Schwann cells, or stem cells, and we can transplant those cells into injured spinal cords,” he says. “It changes the environment to make it more permissive for regeneration and repair.”

One of several intimidating hurdles toward that effort is understanding inhibitory molecules that stop nerve cells from growing. Under normal conditions, some nerve cells do not keep reproducing once enough have been created to sustain life functions. Other cells ensure such growth is stopped as part of the natural life cycle.

“We don’t have all the knowledge necessary to attack that problem,” he says.

One possibility regarding nerve regeneration involves using embryonic stem cells, which potentially can be used to create any manner of human cell like the nerve cell. The branch of research has come under significant fire from those who disagree with its use, claiming it could pave the way toward cloning.

Marcie Roth, executive director of the District-based National Spinal Cord Injury Association, says all the talk of the injured walking again overshadows a more pressing concern.

“It’s sexy to talk about curing spinal cord injuries. It’s not as sexy to talk about the things that will make people’s lives better,” Ms. Roth says.

She says Hawthorne, N.Y.-based Acorda Therapeutics produces a chemical called Fampridine-SR, or 4-AP, which has shown promise in enhancing conduction in damaged nerves.

That chemical could help patients recover some of their bowel and bladder functions, which would let them lead more independent lives.

“That person remains a taxpayer as opposed to needing a higher level of support,” she says.

Ms. Roth bristles that some insurance carriers won’t help patients buy simple, preventive devices such as special cushions for the wheelchair-bound. The appropriate cushions cost up to $450, she says, while a skin ulcer that the cushions prevent could result in medical fees up to $100,000 and take up to five months to heal, during which time the patient can’t sit on the affected area.

One way spinal cord injury patients keep their bodies healthy is to work out in special harnesses that simulate walking motions when used in conjunction with a treadmill.

Naomi Kleitman, a program director with the National Institute of Neurological Disorders and Stroke with the National Institutes of Health, says some researchers hope the harness work does more than keep the muscles in shape and improve bone density levels, which drop with lack of exercise. Such exercise, some believe, might strengthen existing neurological circuits in damaged bodies.

A recent study overseen by Dr. Bruce Dobkin, medical director of UCLA’s Neurologic Rehabilitation and Research Unit, cast doubt on that conclusion, says Ms. Kleitman, who formerly worked with the Miami Project.

The project compared the results of those with spinal cord injuries who “walked” on a treadmill versus those who underwent more conventional rehabilitation techniques such as stretching and strengthening exercises. There was no difference found between the two regarding any improvement in sensory or motor control.

Scientists still have a staggering amount to learn about spinal cord injuries, but Nick Buoniconti says 2004 offers a new perspective for those with injured loved ones.

He recalls a time when “if you mentioned the word ‘cure,’ you were considered a quack,” he says.

Until more advances are made, Ms. Roth says, we should understand those with spinal cord injuries have plenty to offer society. And to themselves.

“What the general public doesn’t know is that there’s life after a spinal cord injury,” she says. “It’s not a fate worse than death.”

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