niques and refined statistical methodologies are opening up opportunities for more closely monitoring the effects of potential therapeutic interventions. Furthermore, significant advances have made it possible to more closely visualize neuronal growth and alterations in vivo and to identify regions of damage to the spinal cord.

• Leveraging progress in treating other conditions. Progress in other fields of research may well be critical in advancing therapies for spinal cord injuries. Insights into neuronal injury and repair are being gained through research on neurodegenerative disorders, and research in other areas (such as understanding the role of stem cell biology in cancer) may prove important.

In acknowledging the opportunities ahead for spinal cord injury research, care must also be taken not to minimize the challenges. Treating spinal cord injury, particularly in the near term, will involve improving functional deficits and quality of life. The complexity of the nervous system, the varied nature of spinal cord injuries, and the severity of the loss of function present real and significant hurdles to be overcome to reach the ultimate goals of restoring total function. The urgent need to cure this devastating condition should not tempt overly optimistic predictions of recovery or time frames that cannot be met.

In 1998 the state of New York established the New York State Spinal Cord Injury Research Trust to focus on funding and coordinating research on therapeutic interventions for spinal cord injuries (see Chapter 8). Monies for this fund are obtained from surcharges on fines for certain traffic violations, as well as from gifts and donations. In 2002, the New York State Spinal Cord Injury Research Board requested that the Institute of Medicine (IOM) examine the current state of research on spinal cord injuries and make recommendations on priorities for research efforts, particularly with a focus on translational research and strategies to accelerate progress in this field (Box 1-1).

The IOM appointed a 13-member committee with expertise in neuroscience, clinical research, trauma surgery, health care, physiology, and biomedical engineering. The committee met four times during the course of its work and held three workshops (Appendix A) to receive input on future directions for spinal cord injury research. Additionally, the committee received input from individuals with spinal cord injuries and from relevant nonprofit organizations.

This report provides the committee’s recommendations for furthering spinal cord injury research. Written for a broad audience that includes