Friday, January 21, 2005

Surgery gives new hope to paralyzed teen

BY PATRICIA ANSTETT ~ FREE PRESS MEDICAL WRITER

Every time Cortney Hoffman feels a sensation running from her hips down through her legs to her toes, it is a signal to her that there's a new spark in her injured spinal cord.

And the tingling continues.

"I feel a lot of tingling, all the time," said Cortney, 18, of Temperance, who returned to Michigan on Wednesday from Lisbon, Portugal, where she had experimental stem-cell surgery Jan. 8 to repair her spinal cord.

While recovering in Lisbon last week, for the first time since a July 2002 auto accident left all but her head and uppermost torso paralyzed, Cortney could feel her mother, Tammi Roe, squeeze her foot and knee.

"I'm still very sore in my neck," Cortney said. "The pain is worse than I expected, but I'd do it again in a heartbeat."

Determining whether the surgery was a success requires two years of exhaustive physical therapy so that patients regain more upper body strength and some movement in their legs and arms. Among the first 37 patients who have undergone the procedure since 2001, a few are beginning to walk, haltingly, with walkers. Several have regained bladder control. There have been no deaths; everyone who has undergone surgery and physical therapy has seen some improvement.

The procedure gives hope to paralyzed people.

Cortney's story has captured international attention. The Rehabilitation Institute of Michigan in Detroit, which is collaborating with the Portuguese surgical team, has received more than 100 new inquiries and hundreds of visits daily to its Web site since Cortney's story appeared in the Jan. 4 Free Press. (For more information, go to www.centerforscirecovery.org or call 866-724-2368.)

The surgery offers a glimpse at the future of medicine. It uses a person's own adult stem cells, extracted with tissue from the upper reaches of the patient's nasal cavity. The cells are then implanted in the spinal-cord injury site.

Stem cells are among the body's most versatile components. They can take on jobs of other cells when placed elsewhere in the body, holding out promise for the eventual treatment of still-baffling diseases, from multiple sclerosis and Parkinson's disease to perhaps diabetes. In Cortney's case, the hope is they will create nerve and blood cells.

Spinal cord autograft surgery costs $47,600, often is not covered by insurance and is available only in Lisbon, though the Rehabilitation Institute hopes to gain federal approval by next year to do the surgery in the United States. Only patients 35 and younger and those who have been injured six years or less are eligible.

For now, the questions are pretty basic: How safe is the operation? How effective? Does it last? Do patients experience any complications?

Besides the pain she reports in her neck, Cortney has lost her sense of smell, a common though temporary problem. "I smelled an orange" a few days ago, Cortney said.

She expects to return to rehabilitation in about a month. She looks forward to driving by herself and walking. After spending 15 days in a foreign country, she looked forward to chilling out.

"My doctor told me to be patient," she said. "Everything has gone as well as can be expected."