Acute Spinal Therapeutics

Research Overview

The acute spinal therapeutics research group has a primary focus on acute care for spinal cord injured patients. Traumatic spinal cord injury (SCI) generally affects young people, many of whom have severe paralysis and functional deficits with ongoing complex social, psychological, and medical needs.

In the majority of cases the initial vertebral injury is compounded by secondary compression of the spinal cord. Patients generally undergo spinal stabilisation and decompression surgery to decompress and stabilise the spine.  Animal and clinical data demonstrate that urgent relief of cord compression appears to greatly improve outcome. However, urgent decompression can be difficult to achieve in humans because of logistical difficulties. Our group has demonstrated in animal models of SCI, that hypothermia can suspend the progressive damage caused to the spinal cord by compression, thereby allowing decompressive surgery to be performed in a clinically achievable time frame (Batchelor et al. 2010, 2011).

The primary objective of our group is to undertake a multi-centre clinical trial of Immediate Cooling followed by Emergency Decompression (ICED). The aim of the ICED trial is to determine whether the combination of hypothermia and early decompression can improve outcomes in patients with severe cervical SCI.

The ICED trial is comprised of 4 projects encompassing process of  care, development of a rapid neurologic assessment for paramedics (SPEED), a safety and feasibility trial of hypothermia and early decompressive surgery, and finally the multicentre trial.

Staff

Collaborators

  • Ambulance Victoria
  • Austin Health
  • Alfred Health
  • Melbourne Health (Royal Melbourne Hospital)
  • Royal Adelaide Hospital
  • Royal Perth Hospital

Funding

  • Immediate Cooling and Emergency Decompression (ICED) for the treatment of spinal cord injury: pilot, safety and feasibility studies (Neurotrauma-Funding Provider Project) awarded by Institute for Safety, Compensation and Recovery Research (ISCRR)
  • Immediate Cooling and Emergency Decompression (ICED) for the treatment of spinal cord injury: pilot, safety and feasibility studies (Project Grant) awarded by NHMRC

Research Publications

  1. Batchelor PE, Kerr NF, Gatt AM, Cox SF, Ghasem-Zadeh A, Wills TE, Sidon TK, Howells DW. Intracanal pressure in compressive spinal cord injury: reduction with hypothermia. Journal of Neurotrauma 2011; 28 (5): 809-20
  2. Batchelor PE, Kerr NF, Gatt AM, Aleksoska E, Cox SF, Ghasem-Zadeh A, Wills TE, Howells DW. Hypothermia prior to decompression: buying time for treatment of acute spinal cord injury. Journal of Neurotrauma 2010; 27 (8): 1357-68
  3. Batchelor PE, Wills TE, Skeers P, Battistuzzo CR, Macleod MR, Howells DW, Sena ES. Meta-analysis of pre-clinical studies of early decompression in acute spinal cord injury: a battle of time and pressure. PLoS one 2013; 8 (8): e72659