Introduction
The ultimate dream for many people with a spinal cord injury (SCI) - or for those who care about someone with SCI - is that a cure will be found as quickly as possible. Every few months a newspaper, magazine, or television show seems to re-port a new "breakthrough" for people with SCI, yet those optimistic reports never seem to be followed by stories of people "cured" of SCI. If these scientific "breakthroughs" are occurring, then why is SCI still incurable? Why don't these "breakthroughs" lead to actual improvements in the conditions of those whom we know have a SCI?

The purpose of this information sheet is to analyze why scientific findings often called "breakthroughs" are of importance to people with SCI and to understand how the term "breakthrough" can be misused. Although an important finding at the basic science level will not lead to an immediate remedy for SCI, progress in basic science is essential to the ultimate goal of finding a cure for SCI.

Spinal Cord Injury - The Problem
When spinal cord damage occurs, its most obvious effect is a loss of sensation or movement below the level of injury. Useful function is eliminated below the site of neural damage. For some rae-son, the body is unable to restore this path of communication, so the consequences are permanent. In contrast, a broken leg will cause some temporary Disability, but eventually the bone will mend. Even with other serious injuries, such as burns, new skin may re-grow, although it often is badly scarred.

The Peripheral nervous system (PNS) includes all of the nerves in the body except for the brain, spinal cord, eye, and optic nerve and is able to heal itself after an injury. For example, if you have a bad cut on your finger you may temporarily lose some sensation if a nerve has been damaged. However, nerve endings in your finger eventually will grow back and re-establish their appropriate connections, as is the case with nerves in the PNS.

With a SCI though, or damage to other Central Nervous System (CNS) cells, the loss of function is usually permanent. This has two fundamental causes. When there is a traumatic injury leading to the death of nerve cells, the CNS is unable to grow new cells to replace the damaged ones. Even more important, however, many of the nerve cells that are injured, but not killed, are effectively unable to grow new sprouts that reconnect with other injured (or uninjured) nerve cells on the other side of the damaged zone. Without such a precise form of reconnection, as can occur following PNS injuries, the loss of function becomes permanent.

Clearly, the long term clinical goal of research in SCI is to develop a means of assisting the nerves in the spinal cord to heal, or regenerate. Before this objective can be accomplished, however, there are some fundamental problems to overcome. The most import-ant dilemma is our ignorance of biological processes normally in control of the growth and Regeneration of the nervous system. In fact, biologists still know rather little about the crucial regulatory systems that allow a single fertilized egg cell to grow into an elaborate animal.

To attempt to find a "cure" for SCI before understanding these basic facts is like trying to bake a cake without knowing the ingredients, the correct amounts of those ingredients, or the temperature at which they would need to be baked in order to come out with a successful finished product. It is, of course, possible to conduct trial and error experiments with cake ingredients and eventually develop a reasonable facsimile of a cake. However, the spinal cord is many times more complex that this proverbial cake! Moreover, it is not yet known for sure the "ingredients" required, much less the relationship of those ingredients to each other and the cellular Environment in which they operate, making trial and error approaches to a cure for SCI unreasonable.

The only way an appropriate "recipe" for spinal cord regeneration can be developed, therefore, is to find the answers to the basic questions about cell formation, interactions between cells and cell death. Once scientists have a fairly good idea about the answers to those questions, it will be possible to begin in earnest the task of finding a way to change the CNS's response to injury to allow for regrowth - or regeneration - of the spinal cord.