Abstract
Introduction: Spinal cord injury (SCI) is a severe neurological disorder following trauma. Complete spinal cord injury ASIA Grade A with quadriplegia / paraplegia patients remains untreated and neglected in our country since long back. Now we planned effective strategy for the treatment of SCI by bone marrow derived mesenchymal stem cell transplantation has emerged as a viable therapeutic option with great potential for restoring neurological function following SCI.
Summary: From January 2016 to February 2017 a total of 10 SCI patient enrolled in our unit IV, Neurosurgery department, Dhaka medical college hospital, Dhaka, Bangladesh. All patients signed and given informed consent was taken prior to autologous bone marrow derived mesenchymal stem cell transplantation and bony decompression, fixation and fusion.
Result: Analysis of surgical outcome revealed significant improvement in motor, sensory and autonomic nerve function as assessed by the American spinal cord injury association impairement scale. 6 months after transplantation, a total of 10 patients, 9 patients demonstrated improvement. Among them 5 patients (50%) with Grade A SCI improved by one grade (i, e; Grade B), 3 patients (30%) with Grade A SCI improved by two grade (i, e; Grade C ), 1 patient (10%) with Grade A SCI improved by three grade( i, e;Grade D). In all patient, post surgical extensive physiotherapy and regular follow up given.
Keywords: Spinal cord injury (SCI),Bone marrow aspirate concentrate(BMAC),American Spinal Injury Association(ASIA).
References
- Recio AC, Felter CE, Schneider AC, McDonald JW (2012) High-voltage electrical stimulation for the management of stage III and IV pressure ulcers among adults with spinal cord injury: Demonstration of its utility for recalcitrant wounds below the level of injury. J Spinal Cord Med 35: 58-63.
- Regan MA, Teasell RW, Wolfe DL, Keast D, Mortenson WB, et al. (2009) A systematic review of therapeutic interventions for pressure ulcers after spinal cord injury. Arch Phys Med Rehabil 90: 213-231.
- Kisala PA, Tulsky DS, Choi SW, Kirshblum SC (2015) Development and psychometric characteristics of the SCI-QOL Pressure Ulcers scale and short form. J Spinal Cord Med 38: 303-314.
- Saunders LL, Krause JS, Acuna J (2012) Association of race, socioeconomic status and health care access with pressure ulcers after spinal cord injury. Arch Phys Med Rehabil 93: 972-977.
- WHO I
- Barnabé-Heider F and Frisén J: Stem cells for spinal cord repair. Cell Stem Cell 3: 16-24, 2008.
- Lim PA and Tow AM: Recovery and regeneration after spinal cord injury: a review and summary of recent literature. Ann Acad Med Singapore 36: 49-57, 2007.
- Satake K, Lou J and Lenke LG: Migration of mesenchymal stem cells through cerebrospinal fluid into injured spinal cord tissue. Spine (Phila Pa 1976) 29: 1971-1979, 2004.
- Koda M, Nishio Y, Kamada T, et al: Granulocyte colony stimulating (G-CSF) mobilizes bone marrow-derived cells into injured spinal cord and promotes functional recovery after compression-induced spinal cord injury in mice. Brain Res 1149: 223-231, 2007.
- Park WB, Kim SY, Lee SH, Kim HW, Park JS and Hyun JK: The effect of mesenchymal stem cell transplantation on the recovery of bladder and hindlimb function after spinal cord contusion in rats. BMC Neurosci 11: 119, 2010.
- Novikova LN, Brohlin M, Kingham PJ, Novikov LN and Wiberg M: Neuroprotective and growth-promoting effects of bone marrow stromal cells after cervical spinal cord injury in adult rats. Cytotherapy 13: 873-887, 2011.
- Yoon SH, Shim YS, Park YH, et al: Complete spinal cord injury treatment using autologous bone marrow cell transplantation and bone marrow stimulation with granulocyte macrophage-colony stimulating factor: Phase I/II clinical trial. Stem Cells 25: 2066-2073, 2007.
- Geffner LF, Santacruz P, Izurieta M, et al: Administration of autologous bone marrow stem cells into spinal cord injury patients via multiple routes is safe and improves their quality of life: comprehensive case studies. Cell Transplant 17: 1277-1293, 2008.
- Kishk NA, Gabr H, Hamdy S, et al: Case control series of intrathecal autologous bone marrow mesenchymal stem cell therapy for chronic spinal cord injury. Neurorehabil Neural Repair 24: 702-708, 2010.
- Wrigley PJ, Press SR, Gustin SM, et al: Neuropathic pain and primary somatosensory cortex reorganization following spinal cord injury. Pain 141: 52-59, 2009.
- Sharp J, Frame J, Siegenthaler M, et al: Human embryonic stem cell-derived oligodendrocyte progenitor cell transplants improve recovery after cervical spinal cord injury. Stem Cells 28: 152-163, 2010.
- Hwang DH, Kim BG, Kim EJ, et al: Transplantation of human neural stem cells transduced with Olig2 transcription factor improves locomotor recovery and enhances myelination in the white matter of rat spinal cord following contusive injury. BMC Neurosci 10: 117, 2009.
- Keirstead HS, Nistor G, Bernal G, et al: Human embryonic stem cell-derived oligodendrocyte progenitor cell transplants remyelinate and restore locomotion after spinal cord injury. J Neurosci 25: 4694-4705, 2005.
Corresponding Author
Dr Sukriti Das
Associate Professor, Department of Neurosurgery, DMCH
Email- This email address is being protected from spambots. You need JavaScript enabled to view it., This email address is being protected from spambots. You need JavaScript enabled to view it.