Hope for the Paraplegic

by Maureen Kennedy Salaman

President, National Health Federation
September 2005

In 1993, Andrea Zobell, a 23‑year old German woman, became paraplegic after a skiing accident.  An MRI showed a fractured vertebra and completely severed spinal cord.  As a result of the injury, she was a motionless paraplegic from the chest down.  She could not speak or hear.

More than three years after her fall, Zobell found Harry S. Goldsmith, M.D., who has developed a method of rejoining severed spinal cords with an innovative surgical procedure that involves using a fatty membrane - called the omentum - taken from the stomach cavity, to stimulate nerve-cell regeneration.

Neurosurgeons know, and medical students are taught, that if the spinal cord is cut in two, you can put it back together and align it, but it will not grow together and heal.  The omentum changes that because it provides neurotransmitters, tissue, a nervous system, nutrients, stem cells, and other compounds to stimulate new blood-vessel growth.

Dr. Goldsmith agreed to treat Andrea.  After removing scar tissue, he discovered that the gap in her spinal cord was larger than he had anticipated.  He filled it in with liquid collagen, then laid the intact omentum over the area and sewed her up, a process called omental transposition.

Over the next several years, Zobell gradually gained strength and control of muscles below the injury.  Because of increased strength in the back, hip, and abdominal muscles, she could remain in a sitting position without support.  She has regained some ability to move her legs.  For example, she can walk when she is in a swimming pool and can get off a chair and stand with some support.  She also has increased awareness of bladder filling.  Importantly, she can both speak and hear now.  Andrea’s MRI now shows the continued development of structure connecting the spinal-cord segments.  In fact, she has gone back to school, earned her degree, and is fully employed now as the progress continues.

Other Case Examples Abound

Brian Sternberg was not just a superb athlete, he was the best.  In 1963, the University of Washington junior established a world pole-vault record of 16’8” and seemed destined to be the first to break 20 feet.  His gymnastic background had made him a strong, agile athlete and, hence, especially well suited for the new, flexible, state‑of‑the‑art fiberglass poles.

Practicing on the trampoline as he often did, Sternberg tried a maneuver that he had routinely carried out in the past.  This time, though, something went wrong. Landing awkwardly on his neck, he sustained a C4‑5 spinal cord injury (SCI).

More than three decades later, in 1996, surgeon Harry Goldsmith operated on Sternberg. Because Sternberg’s injury affected the nerves controlling respiration, he could only speak in a whisper before surgery.  After surgery, his voice increased by about 60 percent.  He also gained more feeling in his extremities, improved circulation, and he can stay upright for long periods of time, a problem before the surgery.  In a Sports Illustrated article (September 21, 1998), Brian stated that the operation “has made all the difference in the world.”

In 1984, Daren Renna was the first person with a spinal-cord injury to be treated by Goldsmith.  Several years earlier, as a 17-year-old, up‑and‑coming gymnast who was setting his sights on qualifying for the U.S. Olympic team, Renna had become a C3‑4 quadriplegic from a gymnastics accident.  His injury resulted in the loss of virtually all function below the neck except for being able to rotate his hands slightly.

Renna says he has benefited greatly from omental surgery.  “I initially got more balance and had less spasticity.  And over the next five years, I regained a lot of arm and wrist function,” he says.  “I have pretty good use of my arms now. Overall, I am a much healthier person.”

Goldsmith was moved when Renna later gave him a gymnastics medal in gratitude. Renna’s improvement has now allowed him to become involved once again in gymnastics, as a coach and internationally-rated official.

Treatment Predictably Discouraged

Not surprisingly, since it counters convention and is successful, omental transposition is considered a controversial surgery when used to treat SCI.

Goldsmith pioneered this procedure for various central-nervous-system disorders, including SCI.  Currently associated with the University of Nevada’s School of Medicine (Reno), Goldsmith has spent much of his career investigating omentum’s therapeutic potential.  His work has encouraged many others who have treated thousands of patients for SCI and other neurological disorders such as stroke, cerebral palsy, Alzheimer’s disease, and Parkinson’s disease.

The procedure’s acceptance has grown greatly in other parts of the world, such as in China where more than 3,000 people with SCI have had omental surgery.  In the United States, however, the conservative SCI research community has been reluctant to evaluate omental therapy for a variety of reasons.

First, many urge caution when considering a therapy that involves the liability of tampering with the spinal cord.  Second, omental surgery’s radical nature falls outside of prevailing SCI research perspectives and priorities.  As such, with an “I'll see it when I believe it” attitude, the SCI scientific community chooses to concentrate on the omental approach’s perceived flaws to reinforce their preconceptions rather than seeing evidence that would encourage them to change their views.

Third, although many have had omental surgery, the value of this therapy, especially when originating in other countries, does not count much in the U.S. scientific court of judgment.  Scientists believe that the only evidence that really matters is that generated by rigorously designed, controlled clinical trials, which have not as yet been carried out for omental surgery.

Some surgeons use a substitute procedure, in which a free, unattached piece of omental tissue is surgically placed over the injured cord and connected to a surrounding vascular source (e.g., to the carotid artery and jugular vein).  Dr. Hernando Rafael in Mexico has mostly used this modified procedure to treat over 250 people with spinal-cord injury.  Although blood circulation is maintained, because the graft is separated from the omentum’s lymphatic system, the tissue’s ability to absorb fluid is eliminated.

Goldsmith and Rafael estimate that about 40 percent of their omental SCI patients have regained some function, and Chinese surgeons have reported an even greater improvement rate.

Goldsmith continues to be a tireless omental therapy advocate.  Several benefactors have recently donated $2 million dollars to establish the Omental Research Foundation to support his efforts.  He plans to use these funds to help defer the high patient cost of the surgery and fund basic‑research pilot studies.

If you, or someone you know, could benefit from this procedure, contact Dr. Goldsmith at P.O. Box 493 Glenbrook, Nevada 89413 USA; 1-775-749-5801 (telephone); 1-775-749-5861 (fax); or e-mail: Hlgldsmith@aol.com.