By Dave Andrusko
A 38-year-old Bulgarian man is believed to be the first person in the world to recover from a complete severing of the spinal nerves, thanks to a pioneering transplant treatment that took cells from his nose. Note: these are not embryonic stem cells, meaning no matter how amazing Darek Fidyka’s recovery is, it will not receive the publicity it warrants.
Following 19 months of treatment, Fidyak can now walk with braces. He has been able “to resume an independent life, even to the extent of driving a car, while sensation has returned to his lower limbs,” according to Reuters.
“We believe that this procedure is the breakthrough which, as it is further developed, will result in a historic change in the currently hopeless outlook for people disabled by spinal cord injury,” explained Geoff Raisman, chair of neural regeneration at University College London’s Institute of Neurology, who led the British research team working on the joint project.
“What we’ve done is establish a principle–nerve fibers can grow back and restore function–provided we give them a bridge,” he told Agence France-Presse. “To me, this is more impressive than a man walking on the moon.”
The actual surgery was performed by a Polish team led by Dr. Pawel Tabakow, from Wroclaw Medical University, one of the world’s top spinal repair experts.
Put briefly, they transplanted “what are known as olfactory ensheathing cells into the patient’s spinal cord and constructing a ‘nerve bridge’ between two stumps of the damaged spinal column,” Reuters wrote. But, of course, it’s a lot more complicated than that suggests and includes a lengthy history of experimentation.
“The breakthrough represents decades of pioneering work” for Geoffrey Raisman, a professor in the Institute of Neurology at University College London in the UK, explained Catharine Paddock for Medical News Today .
“In 1969, he discovered that damaged nerve cells can form new connections, and in 1985, he identified that a type of nose cell–called an olfactory ensheathing cell (OEC)–allows nerve fibers to regenerate into the brain.”
This and other discoveries led Raisman and his team to think that one day it would be possible to regenerate nerve fibers in injured spinal cords.
When the spinal cord is damaged, scar tissue forms at the injured site. This stops nerve fibers from re-growing.
“He and his team focused on the nerve cells responsible for sense of smell because they are the only type of nerve cell known to regenerate. They believed OECs helped to clear the way for the nerve cells to regrow.”
“Prof. Raisman had the idea the nerve fibers might regrow if they had a bridge across the scar,” she added. He spent years trying to find the right materials to produce such a “bridge.”
In the first of two operations, the surgeons removed one of his olfactory bulbs in his nose and grew the OECs in culture. According to Paddock
“Two weeks later, using about 100 micro-injections on either side of the site, they transplanted the cultured OECs into his severed spinal cord, using a strip of nerves from his ankle to bridge the gap.
“The idea was to use the OECs to spur the spinal nerve fibers to regrow across the gap, using the ankle nerve grafts as a bridge.”
As you would expect, Mr. Fidyka is ecstatic.
“When there’s nothing, you can’t feel almost half of your body. You’re helpless, lost,” Fidyak who is now recovering at the Akron Neuro-Rehabilitation Center in Wroclaw, told BBC’s Panorama program. “When it begins to come back, you feel you’ve started your life all over again, as if you are reborn. It’s an incredible feeling, difficult to describe.”