As the 21st century begins to bloom, advances in scientific understanding of the human body are leading to tremendous opportunities for treating even the most devastating diseases. Among the most exciting frontiers in medicine is the repair of traumatic injuries to the central nervous system (CNS), including the spinal cord. Improvements in treatment are helping many more people survive spinal cord injury, and the time survivors must spend in the hospital is half what it was 20 years ago. Yet most spinal cord injuries still cause lifelong disability, and further research is critically needed. The injury of actor Christopher Reeve in 1995 drew the world's attention to the tragedy of spinal cord injury. The incidence of spinal cord injuries peaks among people in their early 20s, with a small increase in the elderly population due to falls and degenerative diseases of the spine. Because spinal cord injuries usually occur in early adulthood, those affected often require costly supportive care for many decades. Spinal cord injuries and its aftereffect create enormous burden to the families who become victims of the aftereffects of these disastrous injuries. The consequences are social, economical, and psychological besides medical and surgical complications. Attempt has been made to portray the larger picture of these injuries and its various ramifications. It is primarily intended for the medical students and general practitioners in understanding of these complex injuries. Research in spinal cord regeneration is catching attention of clinicians and basic scientists. It would almost revolutionise the life and disease outcome of these unfortunate patients if we can work out a cost effective and practical treatment regimen for these victims who are unfortunately in the prime of their productive years. It was gratifying to learn that nerves in peripheral nervous system (PNS), which are outside the brain or spinal cord, did regrow. It is exciting to learn that the prospects of regrowth of spinal cord improve when these PNS cells are implanted in damaged spinal cord. Spinal cord injury is a global epidemic. A lot of research is going on in this field. Axonal regeneration, electric stimulation, Netrins, stem cells etc are few exciting fields in the area of research. It is ongoing research whereby the ability to grow human motor neurons in the laboratory will provide new insights into disease processes and could be used as alternative to animal models for finding therapeutic targets and testing drug. Researchers have identified a wide variety of potential therapies for spinal cord injury. To efficiently evaluate these therapies, however, investigators need to carry out well-designed preclinical and clinical trials that will reveal the benefits and drawbacks of each strategy. While all of these potential therapies appear promising, not all are at the same stage of development. Some neuroprotective drugs, including certain antioxidants and antiexcitotoxic drugs, are already being tested in humans for other purposes. Recently discovered molecules, such as those that control axon guidance, will require a great deal of basic and applied research before they can be developed into useful drugs. With so many potential therapies for spinal cord injury, investigators must carry out efficient preclinical tests to ensure that the most effective therapies proceed as rapidly as possible to clinical trials and, ultimately, to proven safety and usefulness. New animal models and better ways to monitor the success of treatments are essential to this process. A lot has been done. A lot needs to be done. It is the principal responsibility of planners, politicians, sociologists, scientists, researchers to contribute all their might to work on strategies to reduce mortality, contain morbidity and eventually make these unfortunate victms live the life of ordinary denizens. In his humanity can raise its head again!!!!!
About the Author: Prof. Gourishankar Patnaik MBBS, MS(Orth)PhD was born on the 28th August 1960 at Cuttack, Orissa. He had his schooling in the central Indian town of Nagpur. Maintaining a brilliant academic career and being in the top 10 students in the state in the higher secondary certificate examination he entered in the prestigious Government Medical College, Nagpur in 1977. He graduated in 1981-82 being the best graduate of the Nagpur University with seven gold medals which was a record haul. He had distinction in surgery, obstetrics and Gynecology and Preventive and Social Medicine. He finished his Masters in Orthopedics (M.S.) from Nagpur University in 1986. He is a globally recognized orthopedic surgeon with more than 25 years of teaching and research experience in Oman, Nepal, UK, Malaysia besides India.He has authored more than 15 books on topics ranging from anger management, spirituality and orthopedic surgery. Well read and widely traveled Dr Patnaik holds AO trauma fellowship from the University of Alabama, Birmingham, USA. He had many training stints in Europe, Singapore, and Middle East. He holds a postgraduate degree in has post graduate degrees in sociology, economics and public administration besides numerous training stints in trauma, spine surgery and sports medicine.He has attended over 100 training sessions, workshops, seminar and is often invited to deliver guest lectures and chair the sessions.He is the president of South Asia Youth Climate Coalition(SAYCC) and CEO of Osteoarthrtis and osteoporosis Research Initiative (OACRI).Presently He is the Professor and Head of Dept of Orthopedics, Trauma and Rehabilitation, Narayan Medical College Jamuhar, Bihar India. Widely travelled, his research interests include E learning, Distance learning, Spinal injuries, Diabetes and arthritis. He is on the board of many social organizations. He has authored many books and is a prolific orator and teacher. Dr Kumar Anshuman is a young and dynamic orthopedic surgeon working as an Assistant Professor in the same institute.His interest include trauma, spine surgeries and arthroscopy. He had his orthopedic training from Sir Gangaram Hospital New Delhi.A popular teacher Dr Kumar Anshuman furthered his quest of knowledge by attending various courses and workshops in India and abr