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Asian J Transfus Sci. 2019 Jul-Dec;13(2):120-128. doi: 10.4103/ajts.AJTS_44_18. Epub 2019 Dec 3.

Effectiveness of bone marrow-derived mononuclear stem cells for neurological recovery in participants with spinal cord injury: A randomized controlled trial.

Author information

1
Department of Orthopedic Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India.
2
Department of Transfusion Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.

Abstract

BACKGROUND:

Complete lesion after spinal cord injury (SCI) remains irreversible with little hope of neurological recovery. Newer interventions such as re-stimulation of damaged neurons using artificial agents and the use of stem cells for neuronal regeneration have shown promising results.

AIM:

This study was undertaken for evaluating the neurological status of acute SCI participants after stem cell augmentation and comparing them with other treatment methods.

SETTING AND DESIGN:

Randomized controlled trial in the northern Indian population.

MATERIALS AND METHODS:

A total 193 SCI participants of complete paraplegia with unstable T4-L2 injury having thoracolumbar injury severity score ≥4 were enrolled in this study. Participants were randomly allocated for three different treatment modalities, namely, conventional with stem cell augmentation (Group-1), conventional (Group-2), and conservative (Group-3). Neurological recovery after 1 year was evaluated through the ASIA Impairment Scale (AIS)-grading, sensory, and motor scores.

STATISTICAL ANALYSIS:

T-test for sensory-motor score analysis of each group and analysis of variance for comparison of same variables between the groups.

RESULTS:

After 1-year significant difference was observed in the AIS-grade, sensory and motor scores in-Group 1 (P < 0.001). In Group-1 versus 2, the mean difference at 1 year for AIS grade, sensory and motor scores were 0.40 (P = 0.010, 95% confidence interval [CI] 0.075-0.727), 8.52 (P = 0.030, 95% CI 0.619-16.419), and 4.55(P = 0.003, 95% CI 1.282-7.815), respectively. In Group-1 versus 3, 1.03, 19.02 and 7.22 (P < 0.001 for each of the parameters) and in Group-2 versus 3, 0.63 (P < 0.001), 10.49 (P = 0.009), and 2.68 (P = 0.019), respectively.

CONCLUSIONS:

Significant motor neurological recovery and AIS-grade promotion was observed in Group-1 as compared to Group-2 and 3.

KEYWORDS:

Acute spinal cord injury; autologous bone marrow mononuclear stem cells; conventional treatment; neurological recovery; thoracolumbar injury severity score

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