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New Technology II: Helping Paraplegics and Quadriplegics to Walk

The second company that makes a device to assist walking in spinal cord injured patients is Berkeley Bionics. Their exoskeleton is lighter (45 pounds) and more form-fitting, making it easier to maneuver indoors. It can operate for up to 6 hours between charges. The unit does require operator assistance in the form of a pair of canes for balance.

Prices were not available for the products from both Berkeley and Rex. However, the technology looks promising for several reasons. It allows the subject to stand upright, putting weight on their feet. This helps increase muscle tone and maintain joint flexibility. It also decreases pressure problems caused by remaining seated.

These devices are in an early stage right now. As the technology advances, expect to see smaller bionics with better (smoother) computer control, and more access for people with higher spinal cord injuries.

Disclaimer: I have no financial interest in Berkeley Bionics.

(Source: https://www.youtube.com/)
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New Technology I: Helping Paraplegics and Quadriplegics to Walk

Several companies are working on technology to enable people with spinal cord injuries to walk again. Dave MacCalman, a New Zealand Paralympian with a cervical cord injury, recently purchased a robotic exoskeleton from Rex Bionics. This device allowed him to walk for the first time in 30 years. 

This exoskeleton is somewhat bulky (84 pounds), and allows only slow movement. The unit does not use crutches, but does require a modest amount of arm strength to use. It allows walking up slopes and building standard stairs with a handrail. To go down stairs, the user steps down facing backwards. The power supply lasts 3-4 hours.

This technology has only been in development for nonmilitary use for a few years. I expect that great strides (!) will be made as more companies join the fray. Tomorrow I’ll feature an exoskeleton from a US company, and point out the pros and cons of the two devices. 

Disclaimer: I have no financial interest in Rex Bionics.

(Source: https://www.youtube.com/)
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Printing A Whole Kidney?

And so it begins. I wrote recently about using a special version of a 3D printer to print a skin graft (read it here). I also speculated that we could be seeing 3D printers that could eventually print entire organs at some point. Well, leave it to Wake Forest again.

They demonstrated the concept of printing an organ at the 2011 TED Conference (Technology, Entertainment, Design) last week in Long Beach. Now, this was not a working organ, just a concept demo of sample tissue. Nonetheless, this is a preview of things to come. Imagine when we can print up a new kidney to replace the shattered one in the pan on the back table of the OR.

Check out this fascinating video!

(Source: http://video.ted.com/)
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Retained Foreign Objects After Penetrating Injury

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Recently, a Chinese man was in the news after having a four inch knife blade removed from his head after four years. What is the best way to deal with a problem like this?

First, get in the habit of imaging any body part with a penetrating injury. Retained objects can be as simple as gravel or as complicated as the knife blade above. And remember, some patients who have been stabbed present with a simple laceration but don’t want to tell you how they got it. Image before you close it!

Next, don’t remove it. This is common knowledge, but innocent looking objects (pencils, nails) can penetrate arteries and keep them from bleeding while embedded. Unpleasant and sometimes fatal bleeding can ensue if pulled out.

If you do not have specialists versed in the body regions involved in the injury, transfer immediately with the object secured in place. For objects penetrating minimally complex areas like the extremities, surgeons may opt to carefully remove it in the emergency department, or may elect to do so in the operating room.

Injuries to complex areas should undergo high resolution CT scanning so that 3D reconstruction can be performed if needed. The surgical specialists can then plan the operative approach. This is dictated by the anatomy of the area(s) involved and the architecture of the object (think about hooks and barbs). For objects located near critical areas, an operative exposure must be selected that provides access to all portions of it, and allows for rapid vascular control if needed.

This patient had a knife blade break off after he had been stabbed under the chin. It remained partly within the nasopharynx and the tip came to rest behind his left eye. His symptoms included headaches, stuffy nose and bad breath. The picture below shows the badly corroded blade in front of some of his radiographic images.

Knife in head

(Source: http://c.brightcove.com/)
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