Hyperbaric Oxygen Therapy Following a Spinal Cord Injury

Individuals who have sustained a spinal cord injury may have to deal with many challenges as a result of their condition, not only the obvious issue of reduced mobility.

There are often many secondary complications that arise as a result of a spinal cord injury, such as reduced blood flow or an increased inflammatory response.

A great deal of research undertaken over the last couple of decades with the aim of improving spinal cord injury treatment options. The focus has not only been on trying to allow patients to regain mobility, but efforts have also been made to try and alleviate secondary issues related to paralysis, many of which can have a significant impact on the long-term health and wellbeing of the individual.

One method that studies have shown might be effective in treating certain secondary issues arising from a spinal cord injury is Hyperbaric Oxygen Therapy or HBOT.

What is Hyperbaric Oxygen Therapy (HBOT)?

Hyperbaric oxygen therapy (HBOT) has long been used for treating conditions such as decompression sickness.

During the process of HBOT, a the patient is placed in a pressurized hyperbaric chamber and given pure oxygen to breathe. The higher pressure means that the lungs can carry a lot more oxygen than normal, which in turn promotes healing and helps fight infection.

HBOT is used to treat a variety of injuries and conditions, including skin infections, burns and anemia. Where spinal injuries are concerned, research suggests that hyperbaric oxygen therapy can be beneficial in a variety of ways.

Whilst the research to date has shown strong results with the use of hyperbaric oxygen chambers, there is still a lot to be understood. There are also some significant potential side effects that one needs to be aware of. For a start, an individual receiving HBOT is placed in an environment where the air pressure is often three times as high as the normal level, which can impact the patient’s sight and hearing ability.

The high level of oxygen also means that there is a risk of fire, therefore the patient is not permitted to take certain objects, such as battery-powered devices, into the chamber with them.

A hyperbaric oxygen therapy session can last for about two hours and the recommended number that a patient should participate in will differ from case to case and will depend on their individual condition.

Benefits of HBOT Following a Spinal Cord Injury

As mentioned before, there are several secondary issues that individuals with spinal cord injuries may have to contend with. One example is reduced blood flow which occurs as a result of damage to blood vessels caused by the injury. Individuals may also be troubled by a heightened inflammatory response and potential cell death because neurotransmitters are released in excessive amounts following their injury.

HBOT has been shown to:

• Reduce oxidative stress: Too many free radicals in the body will cause significant damage. This happens when there are too few antioxidant enzymes to get rid of the free radicals. HBOT ensures that more of these enzymes are produced, thus reducing the potential for cell damage.
• Reduce apoptosis: This happens as a result of increased oxidative stress therefore it stands to reason HBOT also helps keeps this down. Apoptosis is basically cell death. In addition, HBOT may help maintain adequate nitric oxide levels which are beneficial for neurotransmission.
• Reduce inflammatory response: Our natural immune system is there to fight infection but during an inflammatory response it can start attacking our own cells. HBOT has an anti-inflammatory response by reducing the level of cytokines in the spine as well as reducing gaps between cell membranes. This can also reduce swelling which is often a major factor in the early stages following a spinal cord injury being sustained.
• Increased angiogenesis: This is where new blood vessels are created. HBOT has been shown to improve levels of vascular endothelial growth factor (VEGF). Better blood flow means neurons are protected and may even recover.

Possible Side Effects of HBOT

Whilst the potential of using HBOT in the treatment of spinal cord injuries is exciting, there are risks associated with this kind of therapy:

• Middle ear injuries because of too much pressure.
• Temporary nearsightedness because oxygen toxicity affecting the lens.
• Oxygen toxicity can also cause an overdose that leads to seizures.
• Changes in air pressure may affect the lungs and in severe cases cause a collapse.
• Being trapped inside a narrow chamber for more than a few hours can also make individuals feel claustrophobic.

There have been a wide range of experimental studies carried out with HBOT but few clinical investigations. Those that have been undertaken have shown mixed results to date. The potential to help with secondary complications that arise following a spinal cord injury is promising and it certainly warrants further investigation.