A Polish man who was paralyzed from the chest down after a knife attack several years ago is now able to get around using a walker and has recovered some sensation in his legs after receiving a novel nerve-regeneration treatment, according to a new report that has generated both hope and controversy.
The case, first reported widely by the BBC and other British news outlets, has stirred as much excitement on the Internet as it has extreme caution among many experts.
"It is premature at best, and at worst inappropriate, to draw any conclusions from a single patient," said Dr. Mark H. Tuszynski, director of the translational neuroscience unit at the medical school of the University of California, San Diego.
That patient — identified as Darek Fidyka, 40 — is the first to recover feeling and mobility after getting the novel therapy, which involves injections of cultured cells at the site of the injury and tissue grafts, the report said.
The techniques have shown some promise in animal studies. But the medical team, led by Polish and English doctors, also emphasized that the results will "have to be confirmed in a larger group of patients sustaining similar types of spinal injury" before the treatment can be considered truly effective. The case report was published in the journal Cell Transplantation.
The history of spinal injury treatment is studded with false hope and miracle recoveries that could never be replicated, experts said. In previous studies, scientists experimented with some of the same methods used on Fidyka, with disappointing results.
Depending on their injuries, patients may show what appears to be spontaneous progress without any special treatments.
"You can see surprising improvements in patients engaging in rehab, even long after the injury," Tuszynski said.
And it is often not clear how much spinal cord tissue is spared after an injury, experts said.
Fidyka’s injury was severe by any measure. His spinal column was cut nearly in half at midback, the two pieces connected by a bit of scar tissue. Working in Poland, the medical team first removed one of the two olfactory bulbs from behind his nasal cavity. The olfactory bulbs are rich in cells that support nerve function and help repair damage, and the doctors cultured those cells in the lab. They then injected the cells into spinal tissue at the site of the injury. Surgeons also grafted tissue from the patient’s ankle to help bridge the nerve-repair cells across from one side of the spinal cut to the other — about a third of an inch.
After the knife attack and before his surgery, Fidyka showed no measurable improvement in movement or sensation, the doctors reported.
But five months after the procedure — during which he continued in rehabilitation, doing stretching and locomotion exercises — he began to report sensation and could begin to execute voluntary movements. A video posted by the BBC, and produced in cooperation with the researchers, shows Fidyka, more than a year after the operation, standing on a wooden deck, his hands grasping the railing, looking over a pond.
"The problem with concentrating on one case is that people living with these injuries feel that they are missing out on something life-changing," Tuszynski said, "when that is extremely unlikely to be the case."