The track record for spinal cord injury cure research isn’t so hot. It’s not very long, either. No clinical trial has ever proven structural or functional recovery after SCI; moreover, functional regeneration hasn’t been shown in larger animal models. No such clinical trial has ever made it through phase III of the FDA process, the necessary step before it can become a treatment. But the science behind repair or restoration of the paralyzed body is more energized than ever.
Several human clinical trials are happening now, in both acute and chronic SCI, and more are coming. For the first time, the long slog toward treatments is moving beyond basic science into the hands of industry and commerce.
First, though, about the word “cure”: It doesn’t work — at least when it comes to spinal cord injury. While it used to pretty much mean restored walking, I’ve heard it said a cure is getting so much back a stranger can’t spot any disability. That is a pretty high bar, and for all but very incomplete injuries, asks too much of modern medicine.
If you’re like many people, there’s an overly simple cartoon running in your head, the one about how cure medicine works: one treatment, axons grow, everybody walks. The old American Paralysis Association had a stick figure getting up from his wheelchair; the Miami Project still employs the stick guy, showing incremental progress toward taking a step. APA kept its iconograph going until the mid-1990s, when Christopher Reeve came aboard, at which time he became the living logo for cure, upping the ante on recovery. He challenged the biomedical research community to get a move on, while declaring that he’d be playing tennis by age 50, and then rising up to walk across the room in a computer-generated ad shown during the 2000 Super Bowl.
My own cure cartoon came by way of the Spinal Cord Society 30 years ago. At one of their summer conventions, guest lecturer Eric Shooter, a Stanford scientist and early SCI cure optimist, imagined the broken circuitry of the spinal cord being healed by soaking in a magical cocktail of nerve vitamins. In other words, fertilize the garden and axons will bloom, grow and make nice new connections. Bogus, yes, but not completely irrelevant; many scientists carry on the wo