2004 Directors' Summary Synopsis

TECHNICAL ADVANCES TO PREPARE FOR CLINICAL TRIALS

Transplantation of cells, such as Schwann cells or olfactory ensheathing glia, has been a treatment approach studied extensively in experimental spinal cord injury. A current technique for cell transplantation in humans involves making an open incision, retracting muscle and tissue to expose the spinal cord and injecting the cells. Neurosurgeon and basic scientist Dr. James Guest and his colleagues have developed a less invasive way to transplant cells.

In a recently published study, they explored the feasibility of using an endoscope for the placement of cells into the spinal cord. An endoscope is an instrument inserted through a small incision in the skin that allows the surgeon to see inside the body. Testing the technique in cadaver pigs, Dr. Guest injected cells into the spinal cord using a catheter and needle fed through the endoscope.

An advantage to using this surgical technique is it allows for injection of cells or drugs into the spinal cord without full exposure of the spinal column or spinal cord. It is also desirable as the minimally invasive procedure may reduce the potential complications associated with open spinal surgery. Also, because the procedure can be done under local anesthesia, it may allow more flexibility in when and how often cells can be transplanted.

While further research will be required to refine the technique, Dr. Guest’s study suggests that endoscopic cell transplantation is feasible. The development of surgical techniques of this kind is a major contribution to the field of spinal cord injury especially as cellular transplantation studies are either underway or imminent.