Restoration of locomotion in posttraumatic paraplegics: the multidisciplinary approach and unexpected plasticity of single neurons--facts and fantasy.

摘要: In Europe there are about 300,000 paraplegics and in every country approximately 1000 new cases per year. Treatment requires a multidisciplinary approach with scientific cooperation targeted to exchange personal knowledge expertise. At present completely disrupted spinal cord cannot heal for recovery of motor and/or sensory functioning, although some promising treatment modalities laboratory animal experiments have been reported. No interventional stem cell procedure so far has shown evidence restore impaired functioning human paraplegics. However, functional electrical stimulation (FES) via an implanted neuroprosthesis (SUAW concept) central nervous system-peripheral system (CNS-PNS) connection successfully used alternative compensatory strategies voluntary locomotion. This report is analyse the authors’ experience from two European projects paraplegic. Factors will be identified that might caused one or other pitfall since both surgical reconstructive procedures not adopted by rehabilitation physicians restorative (neuro-)surgeons despite results we achieved. Unexpected plasticity single neurons following CNS-PNS by-pass discussed. Future interventions, example phase 1 prospective multiple centre study on side effects, effectiveness, reliability intrathecal anti-Nogo-A antibodies, presented Chinese implantation critically reviewed.