SPINAL INJURY / Nerve-Graft Surgery Gives Paraplegics Hope

An experimental nerve-graft surgery allowed a paraplegic woman whose spinal cord was severed in an automobile accident to reacquire limited use of her legs, an Italian doctor reported this week at a San Diego conference.

In a 14-hour surgery performed in July 2000, Dr. Giorgio Brunelli of the Universita’ di Brescia in Italy 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 patient first showed movement in her legs in September and since has begun walking with assistance, Brunelli said. The woman had used a wheelchair for five years before the surgery. “It is rudimentary walking--she needs a walker--but she can move,” Brunelli said.

Some doctors are skeptical about the procedure, said Dr. Wise Young of Rutgers University, who has followed Brunelli’s research. Young said the permanent severing of the sciatic nerve guarantees that a patient loses use of the leg muscles--something that may cause problems if better treatments are eventually found.

Brunelli stressed that the surgery is experimental, but said he plans to operate next month on a second patient, a man injured in a November automobile accident. “I will not give any illusions to patients,” he said. He also said the procedure works only if the spinal cord is severed in the thoracic region between vertebrae T-7 and T-11.