Neuroprotective Therapy Using Granulocyte Colony-Stimulating Factor for Acute Spinal Cord Injury: A Multicenter Prospective Controlled Clinical Trial

Abstract

We conducted a multicenter prospective controlled clinical trial to assess the feasibility of neuroprotective therapy using granulocyte colony-stimulating factor (G-CSF) for patients with acute spinal cord injury (SCI). The trial ran from August 2009 to March 2011 and included 45 SCI patients treated within 48 h of onset. Informed consent was obtained from all patients. After providing consent, patients were divided into two groups. In the G-CSF group (19 patients), G-CSF (10 μg/kg/day) was intravenously administered for five consecutive days, and in the control group (26 patients), patients were similarly treated except for the G-CSF administration. We evaluated motor functions using the American Spinal Cord Injury Association (ASIA) score 3 months after onset. The increase in ASIA motor score was significantly higher in the G-CSF group (26.1 ± 18.9) than in the control group (12.2 ± 14.7) (P < 0.01). In cases of incomplete paralysis (18 patients in the G-CSF group and 19 patients in the control group), the increase in motor score was also significantly higher (P < 0.05) in the G-CSF group (27.1 ± 18.9) than in the control group (15.1 ± 15.9). The present results suggest the possibility that G-CSF administration has beneficial effects on neurological recovery in patients with acute SCI. We believe that neuroprotection using G-CSF is an effective therapeutic strategy for acute SCI treatment.