MbShea@PWP@English@UMCP

Abstract:
In the United States, there are approximately 12,500 reported spinal cord injuries (SCI) per year. Most SCIs are experienced by male patients (79%) due to some type of contusion or compression injury. Contusion injuries occur when there is an applied force that is quickly or degree applied and removed from the spinal cord, which causes a focal compression and then subsequent dislodgment of spinal tissue resulting in the severance of axons. Blunt force type traumas are the main cause of these injuries. Compression injuries occur as a result of the spinal cord experiencing a sustained force, for example, a crush injury can result from slipped vertebral discs, dislocation or fracture of the vertebrae, or spinal cord subdural hematomas. There are several current approaches being used to address the problem, one being the neutralization of inhibitory factors, but the issue with this approach is that one of the enzymes involved in the approach, chondroitinase, is thermally unstable and thus does not retain its biological activity for the required amount of time. Another current approach is the stimulation of axonal regeneration, but there are complications that would require more research on growth cones to attain the long distance growth required useful SCI regeneration.The integration of biomaterials to promote repair of SCIs, would aid in solving many of the limitations that the current approaches are experiencing. One of the major roles that biomaterials could play is increasing the accuracy of the delivery of the drug, because most of the approaches are not accurate enough with the drug delivery to provide an efficient treatment. Hydrogels could potentially aid in improving the approach to treating SCIs. Hydrogels could be used to create implantable scaffolds, which could provide a bridge across irregular lesion sites. Hydrogels are ideal for this scenario because they can be directly injected into the lesion site, where polymerization can occur in vivo. The structure and flexibility of hydrogels allow them to fit into irregular shaped lesion cavities because they can form flexible 3D structures that are similar to ECM. Furthermore, hydrogels have the capability to be loaded with growth promoting molecules and Stems cells accelerating the rate of recovery.

Reader's Profile: A skeptical reader would be an experienced scientist that would question the feasibility of the product because of the material properties of the gel itself.

Reader's Response: The treatment idea seems very interesting. But the materials properties are not examples are not examined closely and there might be a mismatch of modulus of elasticity causing the implant to break or dislodge.

V, such a gratifying project. Can you address this reader a bit by explaining what happens to the hydrogels over time? Is the scaffolding permanent or is human tissue recruited to the structure, thereby supporting "natural" healing? I think many readers will appreciate know this. If they scaffolding stays, you can note the inertness of the material, so as to not alarm people about immune responses, etc.

Looking forward to reading about your work.