Dr FehlingsDr. Michael Fehlings, Medical Director, Krembil Neuroscience Centre, recently won the Olivecrona Award for his research in the field of spinal cord injuries (SCI). The award, often referred to as the "Nobel Prize of Neurosurgery," was presented to Dr. Fehlings by the Karolinska Institute, a medical university in Stockholm, also responsible for selecting the Nobel Prize in physiology or medicine.

Each year, the Karolinska Institute reviews the work of neurosurgeons and neuroscientists from around the world for this award and selects one who has made an outstanding contribution to the neurosurgical field.

As a clinician and scientist, who holds the Krembil Chair in Neural Repair and Regeneration, Dr. Fehling's work involves a number of bench-to-bedside treatments that have resulted in clinical trials across North America. This includes research into early surgical management of SCI such as decompression surgery within 24 hours of an injury, and neuroprotective therapies to inhibit cell death. His most anticipated research lies with the possibility of using stem cells to repair and regenerate the injured spinal cord.

This international award is named after the Swedish neurosurgeon Herbert Olivecrona, who is considered a pioneer of modern day neurosurgery. Like Dr. Olivecrona, Dr. Fehlings is a visionary for his time, advancing research and surgery with the ultimate goal of improving the lives of patients with all types of spinal cord injuries from acute to chronic.

UHNews: What kind of progress have we seen in terms of spinal cord injuries?
Dr. Michael Fehlings: Today, almost one in five people are walking away from a major spinal cord injury that previously would have been considered hopeless. This represents remarkable progress for such a complex injury. It wasn't too long ago that many believe there was little that could be done to improve the outcome for those with this kind of injury. At one time surgery was avoided because the goal was basically to prevent any further damage. But attitudes have changed and there is a definite realization that we can improve the quality of life for patients and change outcomes where there was once little hope.

These types of injuries still presents many challenges to surgeons and scientists because after the initial trauma to the spinal cord, there are in many cases, a cascade of secondary injuries that are even more difficult to prevent and treat. But our understanding of how spinal trauma unfolds in the body has grown tremendously.

UHNews: With the combination of surgical techniques and new treatments, the idea of curing spinal cord injuries appears to be more and more of a reality everyday. What is your vision for the future of SCI treatment?
MF: I believe we are in the era of translation, where we have a number of approaches that when taken together could change the outcome for patients with spinal cord injuries. Treatment in the not so distant future for SCI would involve a combination of early surgical intervention such as decompression surgery, coordinated with drug treatments to reduce cell death, which would prevent further damage to the spinal cord and the use of adult stem cells to regenerate lost nerve cells.

UHNews: Are we ready to use stem cells for the treatment of spinal cord injuries?
MF: I believe we are very close to being ready to start human clinical trials for stem cell treatment in patients with spinal cord injuries. Canadians have been responsible for a great deal of discoveries and research in terms of stem cells and we I think we are ready to move that research forward and start using the therapies that have been proven in the lab.

In addition to conducting clinical trails, Canada is also in a position to be a leader in establishing guidelines for how scientists and clinicians around the world moves forward with this type of therapy. If we have a more coordinated approach, we can draw upon the great work that is being done in so many countries while maintaining patient safety standards.

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