title: Spinal cord repair with acidic fibroblast growth factor as a treatment for a patient with chronic paraplegia.
abstract: METHODS
  We present a case of a patient with chronic paraplegia with a complete spinal cord gap resulting from a stabbing injury 4 years ago recovering after an innovative surgical strategy.
  
  
  OBJECTIVE
  To demonstrate the clinical outcome of surgical repair with sural nerve graft with fibrin glue containing acidic fibroblast growth factor in a patient with chronic spinal cord injury.
  
  
  BACKGROUND
  Spinal cord injury usually causes permanent disability, and there had been not effective surgical technique to obtain satisfactory functional motor recovery, particularly in chronic patients. Previous studies have revealed that acidic fibroblast growth factor could promote axonal regeneration and reduce neuronal death in adult rats with spinal cord injury.
  
  
  METHODS
  The spinal cord gap at T11 level was bridged with 4 sural nerve grafts that redirected specific pathways from white to gray matter. The grafted area was stabilized with fibrin glue containing acidic fibroblast growth factor.
  
  
  RESULTS
  Before the operation, the paraplegia was identified as ASIA-C, with a motor score for the right and left legs of 12 and 0, respectively, a pinprick score of 77, and 77 on a light touch of left side limbs. His functional status improved from being wheelchair-bound to being able to ambulate independently with a walker 2-and-a-half years after surgery. At this stage, paraplegia was ASIA-D, with motor scores for the right and left legs of 15 and 12, respectively, 86 for a pinprick, and 86 for a light touch of left side limbs.
  
  
  CONCLUSIONS
  This case demonstrated significant motor recovery attained in a patient with chronic paraplegia following a repair surgery with nerve graft and growth factor.
authors.affiliation: Department of Neurosurgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Henrich
authors.initials: H
authors.lastname: Cheng
authors.forename: Kwong-Kum
authors.initials: KK
authors.lastname: Liao
authors.forename: Su-Fen
authors.initials: SF
authors.lastname: Liao
authors.forename: Tien-Yow
authors.initials: TY
authors.lastname: Chuang
authors.forename: Yang-Hsin
authors.initials: YH
authors.lastname: Shih
mesh_terms: D000328:Adult; D000344:Afferent Pathways / Q000601:surgery; D002921:Cicatrix / Q000601:surgery; D004525:Efferent Pathways / Q000601:surgery; D019054:Evoked Potentials, Motor; D005073:Evoked Potentials, Somatosensory; D015718:Fibrin Tissue Adhesive; D016220:Fibroblast Growth Factor 1 / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007796:Laminectomy; D008280:Magnetics; D008297:Male; D009416:Nerve Regeneration / Q000187:drug effects*; D010264:Paraplegia / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D020127:Recovery of Function; D013119:Spinal Cord Injuries / Q000150:complications; D013497:Sural Nerve / Q000637:transplantation*; D013904:Thoracic Vertebrae; D013979:Tibial Nerve / Q000503:physiopathology; D014182:Transplantation, Autologous; D001750:Urinary Bladder, Neurogenic / Q000209:etiology; D014563:Urodynamics; D014951:Wounds, Stab / Q000150:complications
chemical_list: D015718:Fibrin Tissue Adhesive; D016220:Fibroblast Growth Factor 1