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Friday, 30 August, 2002, 16:22 GMT 17:22 UK
Controversy over spine surgery claim
Wheelchair
The woman was previously confined to a wheelchair
Experimental spine surgery has enabled a paraplegic woman to walk again, a doctor has claimed.

However, spinal experts are concerned about the ethics of the procedure, which they view as untested and highly controversial.

Dr Giorgio Brunelli, of the Universita di Brescia, Italy, revealed details of the nerve-graft surgery at a conference in California.


It is rudimentary walking, but she can move

Dr Giorgio Brunelli
The woman's spinal cord was severed in a road accident.

But Dr Brunelli said that following surgery she has regained limited use of her legs.

In a 14-hour surgery performed in July 2000, Dr Brunelli removed a portion of the 28-year-old's sciatic nerve and used it as a graft to connect the undamaged portion of her spine to muscles in her buttocks and thighs.

He said the graft allowed the regrowth of nerves connected to the central nervous system into the muscle tissue.

The unidentified patient first showed movement in her legs in September.

Dr Brunelli said she had since begun walking with assistance.

Prior to surgery she had been wheelchair-bound for five years.

Dr Brunelli said: "It is rudimentary walking - she needs a walker - but she can move."

Scepticism

However, some doctors are sceptical about the procedure.

Dr Wise Young, of Rutgers University, has followed the research.


We shouldn't be jumping the gun

Dr Dalto Dietrich
He said the permanent severing of the sciatic nerve guarantees a patient loses use of the leg muscle - something that may cause problems if better treatments are eventually found.

Dr Young said: "If the procedure fails, this is a very major loss.

"This concept (that) patients have nothing to lose is terribly wrong.

"One shouldn't assume we will have no therapies for spinal cord injury forever - and this is a 28-year-old woman."

Another spinal cord expert criticised the surgery, never before performed in humans, as ethically questionable.

Caution

Dr Dalto Dietrich, of the Miami Project to Cure Paralysis, said: "Unless you do a very controlled clinical trial, many times you get fooled.

"We shouldn't be jumping the gun. There is a major ethical question about doing these types of procedures in people until there is compelling evidence this is the answer to the problem."

Dr Brunelli wrangled with a medical ethics board in Italy for several years before he received approval to perform the operation.

He said he has experimented on more than 1,000 rats and 40 primates since 1980.

And although he stressed that the surgery is experimental, he plans to operate on a second patient next month.

"I will not give any illusions to patients," he said.

Paul Smith, executive director of the UK Spinal Injuries Association, said the woman's case left a lot of questions unanswered.

He said some people with spinal injuries recovered mobility naturally. The prospects depended to a large extent on whether the spinal cord was completely, or only partially severed.

Mr Smith told BBC News Online: "If this worked, and the woman has a better quality of life, then that is brilliant.

"But it does not mean that it is going to work for everybody, and it would be wrong to raise people's expectations. Lots of people have tried things and sort of regretted it later."

Dr Brunelli presented a video of the woman walking at a meeting of the International Society of Orthopaedic Surgery and Traumatology in San Diego.

See also:

20 May 01 | Health
25 Jan 01 | Health
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