Surgeons may be able to increase the chances of recovery for patients with fresh spinal cord injuries who keep their blood pressure in the newly defined range during surgery according to new research.
For one patient, a father of two who was injured in a surfing accident the creative insight and bench-to-bedside study that followed meant the difference between complete paralysis and resuming his life.
Blood Pressure Control May Help New Paralysis Patients Move More
The researchers used a novel machine-learning technique called topological data analysis (TDA). So named because it borrows concepts from geometric topology to identify patterns in large datasets and uncover previously unknown connections that explain why some people regain some motor control following a significant injury while others remain completely paralyzed.
According to the researchers, the discovery may potentially have implications for people undergoing spinal surgery for more prevalent disorders although additional research is necessary. Many experts have confidence in this research and it may lead to new developments in the treatment of spinal injuries in the long run.
“Topological data analysis helped us to ‘see’ patterns that are difficult for humans to see,” said Ferguson who is also affiliated with the UCSF Weill Institute for Neurosciences.
The study’s authors include representatives from four more institutions as well as TRACK-SCI investigators UCSF-led cooperation of researcher’s clinical researchers and clinicians charged with advancing innovative treatments from the laboratory to the bedside.
Automobile accidents and falls are the leading causes of spinal cord injuries. Several such cases are reported across the country every year and it is among the leading causes of paralysis in young people. It is important to follow safety measures while indulging in adventure sports and other activities.
According to the National Spinal Cord Injury Statistical Center around 18000 persons in the United States suffer from spinal cord injury each year with a cumulative prevalence of around 300000 cases. Car accidents and falls are the leading causes of injury with more than half of all injuries occurring in the cervical spine region of the neck which is associated with increased impairment and catastrophic problems. This is the same trend in several countries with regard to spinal injuries.
The researchers concluded that patients with abnormally high or low blood pressure during surgery had a poorer neuromotor recovery. Maximum recovery was related to a mean arterial blood pressure range of 76-104-117 mmHg which is narrower than the existing guidelines based on smaller clinical studies.
“Interestingly, this work identified the upper limit of the blood pressure range which hadn’t been considered harmful before in clinical practice,” said co-corresponding author Jonathan Pan Ph.D. MD from the UCSF Department of Anesthesia and Perioperative Care. “If the results can be validated in our prospective study it has the potential to provide new guidance on our blood pressure management for patients with acute spinal cord injury.”
The ‘Storm of Cellular Stressors’ Caused by Paralysis
“Damage to neurons in the spinal cord results in abnormal blood pressure regulation limiting blood and oxygen flow to stressed spinal cord tissue and increasing spinal neuron death. Thus accurate blood pressure control is a critical component of spinal cord injury care “Torres-Espin who developed the software pipeline said the goal was to make it open source so that other scientists could repurpose the analytical methods.
“This means a patient who might otherwise rely on humanitarian assistance for their most basic needs may become capable of self-transferring from a wheelchair to a bed walking with assistive devices and tending to some activities of daily living unaided.”
“It all started at Zuckerberg. Without the progress made there, I truly believe the subsequent interventions would not have been as successful.”
