After 44 years of campaigning, Australian football veteran Neil Sachse hopes the development of new digital imaging techniques are set to change the way spinal injuries are treated.
An on-field collision during round two of the 1975 VFL season changed Mr. Sachse’s life, leaving him a quadriplegic.
He still remembers the long process of having his injury assessed.
“They used a pinprick to test what level of injury you are. That still happens today,” he said.
“So nothing’s changed in those 44 years as far as the diagnostic tool is concerned.”
Since the accident, Mr. Sachse has dedicated his life to raising money, through the Neil Sachse Foundation, for research into spinal injuries.
His latest project, run by South Australia’s Health and Medical Research Institute (SAHMRI), began with the creation of a new isotope that can be injected into the arms of spinal injury patients.
“This will change the whole concept of how people are treated from here on in because they’ll be able to see the spinal cord injury in 3D,” Mr. Sachse said.
It has taken a few years, but SAHMRI and the Royal Adelaide Hospital’s spinal unit have been given the green light for a new clinical trial.
Ryan O’Hare Doig, the head of spinal cord injury research at SAHMRI, said the world-first clinical trial would use a PET-CT scan to show where the isotype was sticking to cells that were still living.
“It’s a PET-CT, or positron emission tomography study, which involves injecting a radioisotope into our patients and our isotope sticks to a protein or our target,” Dr. O’Hare Doig said.
“Then we hope that their spinal cord will light up at the site of their injury and will allow us to predict their neurological function and look at their recovery over time.”
Researchers say it has the potential to show changes in the spinal cord over the time of the trial.
They say it could also lead to people being diagnosed earlier so doctors could adjust drug treatments or rehabilitation to improve their recovery.
Researchers hope for ‘significant improvement’
Head of spinal surgery at the Royal Adelaide Hospital, Brian Freeman, warned researchers did not have all the answers yet but said he was hopeful that in two years’ time they would have enough information to write their first paper.
“We think it’s going to be a significant improvement… the current situation is we rely on very detailed neurological assessments after someone’s had a spinal cord injury, and we do that over a number of months and years even,” Dr. Freeman said.
“We have computer tomography scanners, which provide some information. We’ve had magnetic resonance imaging, which again provides really, quite good pictures, but it doesn’t give us the ability to make a prognosis for an individual.
“Patients in that situation are really desperate to know how much they’re likely to recover over that two-year period.”
He said researchers believed the treatment would allow doctors to speed up treatment in the future.
“I think it will give us a lot of information and, for example, [the] plastics team often use nerve and tendon transfers… they want to do those as quickly as possible,” he said.
“We try to keep that to about nine or 12 months post-injury because we’re waiting for the plateau, but right now we often don’t know when that is.
“If the PET-CT says there’s a good prognosis here, then we can go ahead and might even do the tendon and nerve transfers earlier.
“So there are those sorts of implications, how we can speed up and really, you know, maximize the benefits.”
‘The end goal is this becomes users all over the world’
The clinical trial will involve 24 South Australian volunteer patients that are at different stages after an injury.
The earliest will be three months after injury as well as patients who have lived with an injury for 20 to 30 years.
“Currently it’s only a state trial. Even though it’s a world first, we are keeping it within South Australia,” Dr. O’Hare Doig said.
“But eventually we would like to increase our patient numbers, increase the number of sites that we recruit patients from all over Australia. But realistically the end goal is that this becomes a tool that clinicians use all over the world, not just South Australia.”
Ten years ago, Yvie Eglinton was a triathlete training for a world championship event when she had a cycling accident and suffered a spinal cord injury.
She said she remembers being assessed via the pinprick method. Now an ambassador for the Neil Sachse Foundation, she said she was hopeful the research would provide an alternative method.
“I think this sort of scan will help in that and it will really target your rehabilitation,” she said.
“It would be so much better if we could find a cure and don’t have to live like I do. I want my injury to count for something.
“Back when I had my injury, it would have shown how much function my spinal cord could handle.
“Maybe I could have had more physical therapy, more robust therapy rather than just focusing on becoming independent.”
Mr. Sachse was once told he would never see real change for spinal patients in his lifetime — but said he hoped this work would help change the lives of people all over the world.