Spine Surgeons body trashes claims of stem cell repair of spine injury

Stem Cell Therapy is ‘Spineless’ – ASSI

New Delhi, January 22: Just as stray stem cell therapists have started claiming they have succeeded in almost curing spinal cord injury and got immobilized patients due to limbs -torso paralyses stand and moving, Association of Spine Surgeons of India (ASSI) has completely trashed them.

Talking to www.meditoall.com editor in chief Dhananjay Kumar on phone, Dr. H.S. Chhabra, Chief of Spine Service & Medical Director, Indian Spinal Injuries Centre and Secretary, ASSI called all such claims erroneous and said, ‘There is as yet not a single evidence of stem cell rejuvenation of injured spine cord injury in the country. There may of course be some pre clinical evidences on this score. So, thus far there is no role of stem cell in repair of human spine injury. For ASSI, prevention and rehabilitation after injury is the only tool regarding spine injury’.

In ASSI scheme of things cell therapy has no place so far. Every year thousands of people suffer from spinal cord injuries. Road Accidents, fall from the height, sudden traumatic blow to the spine are some of the major causes of Spine Injury. Simple measures for prevention can be effective to prevent this devastating ailment which is afflicting people in India day in and day out.

In response to this, the Association of Spine Surgeons of India (ASSI) has issued a position statement that highlights the broad strategies for prevention of Spinal Cord Injury in developing countries like India.

ASSI’s Position Statement on Spinal Injury:

ASSI Position statement on “Prevention of Spinal Cord Injury”

Spinal cord injury is the most devastating ailment which can afflict mankind. It has serious medical, psychosocial and economic consequences not only on the individual but also the whole family. In tetraplegics all four limbs and torso are paralyzed whereas in paraplegics both lower limbs and torso below the level of injury are paralyzed. The treatment goal is to rehabilitate them comprehensively so that they can lead a happy and meaningful life from their wheelchair.

Across the globe, road traffic crashes are generally the most common cause of spinal cord injuries. There have been no proper epidemiological studies in India. However pilot studies suggest that fall from height may be the most common cause in many parts of India whereas in some other parts it may be road traffic crashes. Domestic falls, fall of load from height, fall while carrying heavy load, diseases (tuberculosis / tumors of spine etc.), violence, sports injuries and water accidents (diving) are the other causes of spinal cord injuries.

Complete spinal cord injuries do not recover neurologically since neurons are not able to regenerate effectively for functional improvement. Hence the dictum “Prevention is better than Cure” is especially relevant for spinal injuries.

For the implementation of any prevention program, it is necessary to define the problem and its extent, develop a prevention strategy and evaluate impact (cost-effectiveness / sustainability and culture specificity) of short and long term programs. The data collected defines the overall problem. The strategy is then developed based on the data and describes the overall plan covering all aspects. Short term programs include targeted campaigns. For example, campaigns for prevention of road traffic accidents have been successful when the young population has been targeted emphasizing the regular use of seatbelts in four-wheeled vehicles & helmets on two-wheelers, observing speed limits, obeying traffic rules, avoiding talking on phone and texting while driving, avoiding driving after consumption of alcohol and not allowing children less than 12 years to sit in the front.

Prevention programs can be translated into action through the 4 E’s of injury prevention and control including Education, Engineering, Enforcement and Emergency Care. An integrated approach involving all stakeholders is essential for success. The stakeholders include funders (national, regional, local Govt., compensation bodies and non-Govt organizations), providers (emergency services, hospitals, community based rehabilitation program, industry, business, statutory bodies, media) and those immediately affected (people with SCI, family and friends, local communities and employees). Political commitment is crucial in this process. Equally crucial is the engagement of local community at every level including community leaders and legislators.

It has been amply demonstrated in many countries that prevention strategies can be practically and successfully implemented to reduce disability, morbidity and mortality cost effectively. Association of Spine Surgeons of India (ASSI) feels that due emphasis should be given by all stakeholders, including the Government of India, to prevention programs for spinal cord injuries. Since strategies of prevention differ from region to region due to epidemiological differences, differences in population distribution (urban versus rural), differences in available resources and differences in mind set of the population, the strategies for prevention should be especially adapted for India.