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Promising Research Could Lead to 'Natural' Restoration of Breathing in Spinal Cord Injury Patients Researchers from MetroHealth Medical Center and Case Western Reserve University have developed a treatment process for spinal cord injury which results in the re-growth of damaged nerves and the restoration of breathing in a rodent model. The study is published in the online July 14 issue of the journal Nature. Spinal cord injuries often occur in the upper part of the spinal cord which can paralyze muscles in the diaphragm, limiting or destroying the ability to breathe without a ventilator. In the technique developed by the researchers, a piece of the host's peripheral nerve is grafted to 'bridge' the damaged section of spinal cord and nourish and guide the re-growth of damaged nerves. Nerve grafting to restore function in arms and legs has been done for nearly a century but has never been successful in the spinal cord. That's because after a spinal cord injury, the structural component of cartilage which is present causes scarring which prevents nerve regeneration. The key to this new, successful process is the introduction of an enzyme, which researchers determined could break down these regeneration-blocking molecules and help nerve cells generate new connections. "This is exciting because, although the study was done in a rodent model of spinal cord injury, it further strengthens the idea that regeneration of severed nerves is possible and — when combined with our enzyme treatment — restoration of muscle function is possible in humans," said Warren J. Alilain, PhD, lead author of the study and a researcher with MetroHealth's Department of Neurosciences. "This is certainly not the 'cure,' but one of the key steps needed to get there." Three months after the treatment procedure, tests recording nerve and muscle activity showed that 80 to more than100 percent of breathing function was restored, and breathing function was maintained at the same levels six months after treatment. While the researchers agree that further studies are needed, they are hopeful this technique will soon be tested in clinical trials. Study Shows Treating Femur Fractures Quickly Reduces Complications and Lowers Costs Stabilizing femur fractures early — within 24 hours — can improve patient outcomes and reduce costs for hospitals, according to the latest study of a five-year research project led by MetroHealth orthopaedic traumatologist Heather Vallier, MD. Review of records for 756 patients with multiple injuries treated between 1999 and 2006 indicated that setting fractured femurs earlier was associated with fewer complications than waiting to set the fractures while the patient was further stabilized. Early treatment produced fewer complications, including a decrease in pulmonary problems and pneumonia, which lowered hospital costs because patients required shorter hospital stays, fewer days in the Intensive Care Unit (ICU) and fewer days on a ventilator. These studies counter previous industry research which suggested that certain types of patients may experience more complications when treated with protocols including early definitive stabilization. "Our research has shown waiting to stabilize fractures increases the risk of complications by three to four times," said Dr. Vallier. n