Clinical observation of umbilical cord mesenchymal stem cell transplantation in treatment for sequelae of thoracolumbar spinal cord injury.

Hongbin Cheng,Rongrong Hua,Xiaodong Wang,Yihua An,Guanghui Dai,Xuebin Liu,Jianhua Gao

doi:10.1186/s12967-014-0253-7

Abstract

BackgroundUmbilical cord mesenchymal stem cells (UCMSCs) have a considerable advantage and potential in treating for central nervous system diseases and have become a novel alternative treatment for spinal cord injury. This study aims to compare the neurological function outcome of stem cell transplantation, rehabilitation therapy, and self-healing for sequelae of spinal cord injury.MethodsThirty-four cases of thoracolumbar spinal cord injury were randomly divided into three groups: the stem cell transplantation group was given CT-guided UCMSC transplantation twice; the rehabilitation group received rehabilitation therapy; and the blank control group did not receive any specific treatment. AIS grading, ASIA scoring, the manual muscle strength and muscle tension scale, and the Barthel index were used to evaluate the clinical outcome. Urodynamic examination was also performed for patients in the UCMSC group and the rehabilitation therapy group.ResultsSeven of the ten patients in the UCMSC group had significant and stable improvement in movement, self-care ability, and muscular tension; five of the forteen patients (36%) in the rehabilitation group also had certain improvement in these aspects. Urodynamic examination demonstrated that patients in the UCMSC group exhibited an increase in maximum urinary flow rate and maximum bladder capacity, as well as a decrease in residue urine volume and maximum detrusor pressure. The rehabilitation group exhibited decreased maximum bladder capacity, but no perceptible change in maximum urinary flow rate, residue urine volume or maximum detrusor pressure.ConclusionsUCMSC transplantation can effectively improve neurological functional recovery after spinal cord injury, and its efficacy is superior to that of rehabilitation therapy and self-healing.Trial registrationThe present clinical study was registered at chictr.org (registration number: NCT01393977).

Highlights

Umbilical cord mesenchymal stem cells (UCMSCs) have a considerable advantage and potential in treating for central nervous system diseases and have become a novel alternative treatment for spinal cord injury
Thoracolumbar spinal cord injury has a relatively high rate of incidence, and reports have indicated that cervical, thoracic and lumbar spine injuries account for 4.9%, 28.0%, and 65.9% of total thoracolumbar spinal injuries, respectively [1]
Inflammatory factor secretion, and arachnoid rupture after injury may result in disorders in local cerebrospinal fluid circulation that lead to aggregation of toxic substances and blockage of neurotrophic factors transporting to the site of injury

Summary

Introduction

Umbilical cord mesenchymal stem cells (UCMSCs) have a considerable advantage and potential in treating for central nervous system diseases and have become a novel alternative treatment for spinal cord injury. This study aims to compare the neurological function outcome of stem cell transplantation, rehabilitation therapy, and self-healing for sequelae of spinal cord injury. Axon fractionation and extensive demyelination after spinal cord injury may impede neural regeneration. Tthrombosis, rupture and occlusion of blood vessels supporting the spinal cord may lead to ischemia and hypoxia; micro-environment changes at the damage site can cause massive inflammatory cell infiltration and inflammatory cytokine release that impede neural regeneration. A local glial scar may form after injury, which impedes axon growth [8,9,10,11]. These factors represent the obstacles in neurofunctional recovery that cannot be overcome by conventional rehabilitation therapy

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