8. How to Treat: Paraplegia
ReWalk at MossRehab
The last day Dan Webb could walk on his own was October 4, 2010, when he fell out of a tree on a hunting trip and landed flat on his back. “I knew instantly,” the 42-year-old from Warminster says. He’d suffered a burst fracture of his T9 vertebra and was paralyzed from the waist down.
Webb spent two weeks in the hospital before beginning rehab. He’d heard about a new therapy machine at MossRehab called ReWalk, a robotic device that gives paraplegics the ability to walk upright. Tiny sensors pick up subtle movements in the user’s body and send signals to motors in the hip and knee. A slight lean forward means you want to move; the legs take a step. By getting patients moving, ReWalk helps them retain bone mass, alleviates pressure sores, and reduces muscle spasticity.
Moss physiatrist Alberto Esquenazi helped develop the technology with engineers in Israel. To date, fewer than 100 people around the world have used a ReWalk; Moss is one of a handful of institutions to have one.
Today, with almost 40 ReWalk sessions under his belt, Webb’s a natural, though he says the machine took some getting used to: “It’s like when you golf and your wrist turns just so and everything goes wrong. It takes concentration.” Right now, ReWalk is only available for use in hospitals, but the manufacturer is working on a model for patients to use at home. The institutional version costs around $85,000; the personal one will cost significantly less.
Webb plans to be one of the first ReWalk owners. “There aren’t too many spinal patients who can get up and walk,” he says. “As long as I’m doing the ReWalk, I won’t give up on my legs.”
Philadelphia hospital behind this medical breakthrough: MossRehab
9. How to Treat: Brain Damage
Lokomat Pro therapy at Bryn Mawr Rehab
For patients with brain damage who are learning to walk again, Lokomat therapy is part workout, part video game. It includes a harness and handrails to provide upper body support and stability, braces to guide the legs, and a treadmill to allow for continuous motion; a computer screen gives real-time feedback, with a therapist providing encouragement. Repeating movements over and over lets the brain reforge the connections that make them stick; eventually, patients are weaned off the stability aids and learn to walk without assistance. Bryn Mawr has successfully used the therapy for patients with spinal cord injuries, stroke, Parkinson’s, multiple sclerosis and cerebral palsy.
Philadelphia hospital behind this medical breakthrough: Bryn Mawr Rehab
10. How to Treat: Chronic Wounds
Wound healing at Drexel University College of Medicine and Temple University Hospital
Every year, 80,000 diabetics in the U.S. lose a leg or foot due to wounds that won’t heal and become infected. Two Philadelphia facilities are tackling the problem—and saving lots of limbs in the process. At Drexel, a biomedical engineering team has created a handheld device that helps doctors predict—with 90 percent accuracy—if, and how quickly, a diabetic’s wound will heal. It uses infrared imaging to track the healing process, and can help doctors come up with the most effective treatment plan. Temple’s Limb Salvage Center has just started a clinical trial for a new treatment that could speed the healing process. Stem cells extracted from a patient’s bone marrow are injected into the affected area, to grow new blood vessels and restore circulation. “We’re using the patient’s own body to generate the repair mechanism, rather than bringing in something from the outside,” says Eric Choi, Temple’s chief of vascular surgery. “If this works, amputation might not be a patient’s only option.”
Philadelphia hospital behind this medical breakthrough: Drexel University College of Medicine and Temple University Hospital
11. How to Replace Lost Limbs
Vascularized composite allotransplantation (VCA) at Penn Medicine
Last September, a 28-year-old Virginia woman who’d lost her hands and feet to infection got a gift: new hands, courtesy of HUP surgeon L. Scott Levin and his 30-member transplant team. Every step of the 11.5-hour operation had been thoroughly rehearsed: “I had a playbook, just like a coach,” Levin says. Daunting though the operation sounds, Levin insists it’s no more technically difficult than reattaching a finger or toe. The hard part is the waiting: “If the nerves didn’t regrow, the operation would be for nothing.” They did. “We thought it might take a year. But she’s moving her fingers, picking things up—and it’s only been six months.” Levin predicts a forthcoming “explosion” of VCA as doctors learn to better manage donor/host rejection: “I’m wildly enthusiastic about the future.”
Philadelphia hospital behind this medical breakthrough: Penn Medicine
12. How to Treat: Leukemia
A vaccine against cancer at Penn Medicine
Imagine a vaccine that could stop deadly leukemia in its tracks. University of Pennsylvania researcher Carl June has been doing just that for 20 years. Now, in an experimental gene transfer procedure that’s ignited a firestorm of interest, he’s successfully turned three patients’ own immune-system T cells into “serial killers.” June removed the T cells, modified them to bind to a particular protein found on tumor cells, and reinjected them into his patients. Not only did they wipe out the tumors; they triggered the dying cells to produce a chemical that caused other modified T cells to multiply and attack, bolstering the patients’ ineffective immune systems. “It’s like putting Barry Bonds on steroids,” June says. “It worked much better than we thought it would.” June is extending the research to earlier-stage and pediatric leukemia patients, hoping to win FDA approval. Then he’ll try applying the technique to solid tumors, like those of the prostate, breast, lung and brain.
Philadelphia hospital behind this medical breakthrough: Penn Medicine
13. How to Treat: Ovarian and Colon Cancer
Hyperthermic intraperitoneal perfusion chemotherapy at Drexel University College of Medicine/Hahnemann University Hospital
Wilbur Bowne is in the hope business. Last year, Bowne, chief of gastrointestinal surgery at Drexel University College of Medicine, began offering a new treatment meant to prolong the lives of patients with advanced abdominal cancers—ovarian, colon, appendiceal—who’ve been told they have very little time left. First, surgeons remove as much of the tumor as possible. Then, while still on the operating table, the patient receives a catheter flush of heated chemotherapy that kills remaining cancer cells. Clinical trial results have been promising: 60 percent of colorectal patients who were given six months or less to live reached the two-year survival mark, and 45 percent lived to five years. “This isn’t a cure,” says Bowne. “But it can extend life far beyond expectations and allow for a quality of life previously unheard-of.”
Philadelphia hospitals behind this medical breakthrough: Drexel University College of Medicine/Hahnemann University Hospital
14. How to Treat: Atrial Fibrillation
Cryoblation at Doylestown Hospital
As boomers age, doctors are bracing for an epidemic of this leading cause of stroke in the U.S. and major cause of congestive heart failure. Faulty nerve connections where the pulmonary veins meet the heart create an electrical overload the heart can’t handle. Electrophysiologists John Harding and Robert Sangrigoli thread a catheter from the groin to the heart, search for “hot spots” with a GPS-type mapping system and electrical recordings, and inflate a balloon that injects nitrous gas to freeze nerve tissue, in a technique only recently approved by the FDA. “We were early adopters at Doylestown,” says Harding.