Overcoming a spinal cord injury
New stimulation procedure shows promise, but is not available in Canada
The boat Dion Regular was working on 20 years ago was suspended in the air by a cradle.
As he began to get down from the scaffolding, the plank he was standing on turned over, sending Regular toward a twoand-a-half-inch nail that was keeping it together.
The nail entered the back of his skull, missing his brain, and as his neck snapped back, three bones in his spine broke.
“This happened out in central,” Regular said. “They wouldn’t let family come (on the air ambulance) because (they said) I probably wouldn’t make it to St. John’s.”
He did make it to St. John’s. But while there, the doctors told him he was paralyzed from the neck down and would never walk again.
When his family joined him, they asked the doctors to operate on his kneecap, which had been crushed in the fall.
“They (said), ‘You know, if he does survive, he’s going to spend the rest of his life in bed anyway,’” Regular said.
A year later, he went back to the doctor’s, pushing himself in a manual wheelchair.
“The surgeon actually looked at me and had to sit down,” he said. “He was like, ’You’re not Mr. Regular,’ and I’m like, ‘Yes I am.’”
Regular said everyone has their own opinions on why his recovery went well beyond the doctor’s expectations. For him, his son was the biggest factor.
“I had a nine-month-old at the time,” he said. “When I seen him, and not being able to hold my own son or pick him up, that was motivation.”
Regular would lie in bed at night for hours, just trying to move his fingers. He’d move his head to ring a buzzer for the nurse and tell them he was moving his fingers. But given how bad his injury was, the nurses didn’t believe him.
“My perspective was, I want to get better,” he said. “I don’t want to go home the way I am.”
Now, Regular is a peer support specialist with Spinal Cord Injury Newfoundland and Labrador (SPI-NL). He helps people who find themselves in a similar position as he was in 1999.
“I provide counselling, some one on one, tell my story,” he says. “Then also I assist in community rehabilitation. So, anything from getting that individual back into the community, living the life close to what they had before.”
The physical aspect is just one part of what happens to a person when they have a spinal cord injury. Foot, skin and leg care become problems, as do issues with sexual function, as well as bowel and bladder control, and the potential for diabetes. Much of this happens because of the lack of movement.
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But research is leading scientists to understand more about how the spine works. And with this knowledge, they’re capable of better understanding how to help someone with a spinal cord injury reduce some of these potential problems.
Kevin Power, an associate professor in the school of human kinetics and recreation at Memorial University, does research on how the brain and spinal cord work together to produce movement. He says the link between the upper and lower body is within the spinal cord itself, and gives the example of a newborn baby.
“When you are born, the first way you move about your environment is you crawl,” he says. “This crawling motion (is) actually a very complex (movement).”
Because of this link between the upper and lower body, exercising the arms can affect the health of the lower body.
“In my lab, we use arm cycling or arm peddling,” he says. “If you engage in something like arm cycling you can actually facilitate the regain of (movement in the legs).”
A new procedure, called epidural spinal stimulation, was recently performed in Thailand on Ryan Straschnitzki, a survivor of the Humboldt Broncos bus crash in 2018, which paralyzed him from the chest down.
Surgeons place stimulating electrodes below the break in the spinal cord, as well as on top of a protective layer that surrounds the spine, called the dura mater, Power said.
There are only educated guesses about why this works, Power says.
“What’s probably happening is … with a spinal cord injury, it may not be a complete cut (and) there may be some input from the brain reaching the spinal cord, but not enough to turn the spinal cord on,” Power said.
In other words, the cells in the spinal cord are still functioning, he says, but they can’t receive the "go" signal from the brain.
“(This) we would call sub-threshold — there’s just not enough excitation (of the spine),” Power says.
“When they turn this (stimulator) on, think of it as taking the spinal cord and raising the excitability up. You’ve raised the responsiveness or the excitability of the spinal cord so that this weak descending signal from the brain is sufficient to activate those cells.”
In an emailed statement, Health Canada said spinal cord stimulators have been licensed for pain relief.
“However, the department has not licensed a spinal cord stimulator device for regaining motor skills or sensory functions following spinal injuries, nor received an application for this intended use as of yet,” the statement read.
While it’s possible this technology could make its way to Canada, Regular says anything that helps get the blood flowing through the body has the potential to reduce health issues associated with spinal cord injuries.