Spinal cord traumas are among most severe disorders affecting individuals because of severe motor handicaps and drastic unexpected onset of injuries. In Italy, they represent the first cause of disability and the a great challenge from a health system perspective.
Spinal cord is the pathway carrying nerve signals from brain to all peripheral parts of the body: it is cointained in a bone structure covering the whole vertebral column, from cranium to sacrum, and is made by descending motor nerve fibres and ascending sensory nerve fibres.
Spinal cord traumas can be classified in either complete or incomplete depending on the partial or total functions loss under the injury that are caused by the interruption in ascendant and descendant pathways connecting spianl cord to brain. From a clinical perspective, in the first case no motor or sensitive function will be registered under the injury level and in most severe cases limbs will be flaccid, bone/tendon reflexes as well as sphincters motility will be absent; in the latter, residual spinal cord functionalities will be still present and prognosis will be definitely better. Main problem is linked to the absence of regeneration within the affected region and consequent scar tissue fibrosis preventing from injured nerve regeneration. Scientific advancements have been reached during last decades, bu no cure has been found so far: interrupted or damaged axons regeneration and related functions (motor, sensor, anatomical) restoration are still problems to be solved.
There is still no treatment to restore lost functions: only few therapies oriented to prevent further damages (methylprednisolone and decompressive surgery) and to guarantee patients’ independence (rehabilitation and assisting facilities in everyday life) are available.
Apoptosis is an inevitable consequence after a similar injury, although spinal cord contains stem cells/progenitors, called Neural Precursor Cells (NPCs), which are responsible for nerve system cell turnover. Unfortunately, NPCs bear a too limited proliferative activity to regenerate damaged tissues. Consequently, many engraftment strategies have been approached in animal models of spinal cord trauma.
Both biological and synthetic guides have been recently produced for a higher adhesion and proliferation rate of combined stem cells.
Tissue engineering represents an innovative tool through the use of scaffolds, growth factors, autologous stem cells.
Platelet –derived growth factors prevent from side effects like allergies or intollerances as they are patient-derived products; moreover, they promote clotting, absorbable within few days, for tissue bond and stimulate regenerative processes, vascularization, damaged tissue restoration.