John Follain, MontecatonePhotograph: Nick Cornish
Mending broken bodies
THE wheelchair-bound Superman actor, Christopher Reeve, has criticised an experimental nerve transplant carried out in an attempt to help an Italian woman walk again after she was paralysed in a car crash.
The revolutionary surgery was performed on Gigliola Centurelli, 27, who was married only last year and has been in hospital since her accident five months ago.
A length of sciatic nerve - the largest in the body, running from the pelvis to the thigh - was removed. It was then re-
attached to Centurelli's spinal cord above the point where it had been severed, and joined to three hip muscles that normally control movement of the legs.
The operation was carried out by Professor Giorgio Brunelli, of Brescia University, after 20 years of tests on animals, including monkeys. However, Reeve, who was paralysed from the neck down after falling from a horse five years ago, warned against experimental surgery for the sake of research.
"I think it's pretty immoral because you have to follow a sequence," said the actor, who has vowed to stand again by his 50th birthday in 2002, and has raised huge sums for spinal research. "You've got to go from rats, a lot of rats. Then you have to go to bigger animals, pigs hopefully, not monkeys. You've got to demonstrate safety and efficacy."
Reeve's concern was rejected by Centurelli, who said she had nothing to lose. Confined to her bed in the hilltop Montecatone Rehabilitation Institute near Bologna for a month since the operation, she will be taken to its gymnasium for massages and electro-stimulation this week, at the start of a long process to determine whether the surgery has been a success.
"I want to be a bit more independent," she said. "Just taking a few steps is my greatest dream."
Centurelli was a barmaid with "no children, thank God", who remembers little about the Saturday last March when she left her home in the northern city of Bergamo to go to the dentist. On the return journey, her Lancia ploughed into a field, rolling over. She was not wearing her seat belt, her spinal cord was severed, and she spent three weeks in a coma.
"What I miss most of all is my work," she said. "Bad luck - it was fate."
Her husband, Alfredo, sought out Brunelli, who had already operated on another patient paralysed in a fall from scaffolding, taking a nerve running from the spinal cord through one of his arms, and attaching it to a leg muscle. The man is now able to walk short distances.
"But I took the decision alone," Centurelli said. "I thought it's my life, I must try."
Brunelli says a rerouted nerve should regenerate at the rate of 1mm a day. Centurelli's surgery may re-establish communication between the nerves above her injury and the muscles below it 18 months from now, he believes.
He warns patients not to delude themselves. "The gains are marginal. We are still in the Stone Age as far as spinal cord injuries are
concerned. I am not peddling illusions - I am experimenting on
Brunelli plans only another half-dozen operations before pausing for up to two years to judge the results.
Reeve doubts whether the time is right to experiment on people. "You've really got to test everything, and then do it on a limited number of humans who are at a low-level risk in case of failure," he told Channel 4 News.
Brunelli's methods have aroused further scepticism in London. "What he is doing is controversial," said Martin Ferguson-Pell, professor of disability and technology at University College London. "At the moment procedures such as these provide a very limited degree of movement."
Centurelli now faces two years of physiotherapy. "What will happen when I try to stand on my two feet I just don't know," she said.