Spinal cord injuries can prove to be highly debilitating for any individual as they can hamper the quality of life in a significant manner. When a person suffers from a spinal cord injury, the same is generally caused by trauma, either because of degeneration or diseases that affect that part of the body. However, the extent and symptoms of the spinal cord injury depend on the severity and location. Besides chronic pain, a spinal cord injury can also result in partial or complete loss of sensory function and motor loss of arms, legs, and body. It can also affect bladder or bowel movements, blood pressure, heart rate, and breathing processes, making recovery challenging and burdensome.
One of the most critical factors that can play an essential role in helping patients recover from spinal injury is the process of angiogenesis. Defined as the formation of new blood vessels, angiogenesis involves the migration, growth, and differentiation of endothelial cells, which line the inside wall of blood vessels. Chemical signals in the body control the process of angiogenesis. Further, these blood vessels grow from the existing blood vessels or the arrangement of blood vessels in a part or organ of the body.
When a person suffers from a spinal cord injury, the human body automatically initiates the angiogenesis process used to develop a new vascular system. This process helps to ensure the effective distribution of adequate blood supply and axonal recovery. Additionally, the restored blood flow will deliver oxygen and nutrients to the damaged tissue, enabling the growth and functioning of the reparative cells.
Another critical factor that can affect healing through angiogenesis is the amount of Vascular Endothelial Growth Factor (VEGF). It is a potent and proangiogenic growth factor in the skin, and the extent of its presence in the wound can significantly help in the healing and recovery process of a patient. In fact, according to recent research, the VEGF receptor (VEGFR) has also been noticed in many other cell types that repair the wound, as against earlier studies that suggested that VEGF activity was only restricted to the endothelial cells that line up the blood vessels.
During the recovery process, local hypoxia and proangiogenic substances in the injury site help initiate the angiogenesis process. The method includes three main formations: vasculogenic, splitting angiogenesis, and sprouting angiogenesis. Vasculogenic refers to the growth of new vessels from angioblasts or existing endothelial cells. These new vessels use the pre-existing vascular system and play a vital role in helping a patient recover.
In conclusion, angiogenesis and sufficient capillary blood flow have proved to be practical tools for functional regeneration and tissue survival, especially for patients who have suffered from spinal injuries. Multiple successful interventions have triggered angiogenesis and provided adequate blood supply and vascular decency for promoting axonal guidance and functional recovery in patients with these types of injuries.
However, many unspecified aspects of pathophysiological and angiogenetic processes still need to be evaluated further to play a more significant role in the recovery process. In the future, it is hoped that neurosurgery advancements will enable the establishment of favorable conditions, enhancing angiogenesis and functional recovery in patients with spinal cord injuries faster and smoother.
Author
Dr. Gurneet Singh Sawhney, Senior Consultant – Neurosurgery
Fortis Hospital, Mulund
