Brian Sternberg was not just a superb athlete; he was the best. In 1963, the University of Washington junior established a world pole-vault record of 16'8" and seemed destined to be the first to break 20 feet. His gymnastics background had made him a strong, agile athlete, especially well-suited for the new, flexible, state-of-the-art fiberglass poles.

Practicing on the trampoline as he often did, Sternberg tried a maneuver he had routinely carried out in the past. This time, something went wrong. Landing awkwardly on his neck, he sustained a C4-5 spinal injury.

More than three decades later, in 1996, surgeon Harry Goldsmith operated on Sternberg, who says the omental procedure greatly increased Sternberg's quality of life. For example, because the injury affected the nerves controlling respiration, Sternberg could only speak in a whisper before surgery. Since then, his voice increased by about 60%.

"I wouldn't have been able to have this conversation with you before the operation," Sternberg told me. He says his overall health and strength have greatly improved. For example, the operation has reduced the incapacitating pain he once had.

"Before the surgery, on a scale of 1-10 [with 10 being the most severe], my pain averaged 8-13," Sternberg says. "Now it is 1-2."

He has more feeling in extremities and improved circulation. He can stay upright for long periods of time, a problem before the surgery. In a Sports Illustrated article (September 21, 1998), Sternberg said the operation "has made all the difference in the world."

Omental transposition is a controversial surgery used to treat spinal-cord injury (SCI). In this procedure, the omentum, a physiologically dynamic, fatty membranous tissue surrounding the intestinal and lower abdominal region, is surgically lengthened and placed over the area of injury.

Currently associated with the University of Nevada's School of Medicine (Reno), Goldsmith has spent much of his career investigating omentum's therapeutic potential. His work has stimulated many others who have treated thousands of patients for SCI and other neurological disorders such as stroke, cerebral palsy, and Alzheimer's and Parkinson's diseases.

The procedure's acceptance has grown greatly in other parts of the world, such as in China where more than 3,000 people with SCI have had omental surgery. In the United States, however, the conservative SCI research community has been reluctant to evaluate omental therapy for a variety of reasons.

First, many researchers urge caution when considering a new therapy like this that involves an inherently risky surgery that tampers with the spinal cord. Second, omental surgery's radical nature falls outside prevailing SCI research perspectives and priorities. Third, although many people have had omental surgery, the value of this clinical experience, especially when originating in other countries, does not count much in the U.S. scientific court of judgment. Fourth, the therapy's image received a blow after a mid-1990s controversy in which an unauthorized recruiting agent was accused of over-promoting omentum's therapeutic benefits.

Nevertheless, Goldsmith continues to be a tireless omental-therapy advocate. Several benefactors recently donated $2 million to establish the Omental Research Foundation to support his efforts. He plans to use these funds to help defer the high patient cost of the surgery and fund basic-research pilot studies.

There is too much supporting research and patient experience to continue ignoring omentum's therapeutic potential. The verdict is not in for this procedure as many of us falsely concluded in the past. We need to open-mindedly gather more evidence, especially well-designed, controlled clinical trials to help definitively determine the procedure's benefits relative to its risks.



S. Laurance Johnston, Ph.D., is a biomedical and disability-research consultant. He has 18 years of experience in Washington, D.C., as a senior science administrator at private research foundations, the National Institutes of Health (NIH), and the Food and Drug Administration. He authors a column in PN/Paraplegia News called Healing Options, which focuses on alternative treatment methods. Contact: 107656.2604@compuserve.com.