Transplantation and BM stimulation therapy: combined approaches for repair of spinal cord injury

초록

Objective: General management strategy of complete spinal cord injurypatient after trauma were included as high dose methyprednisolone infusion, surgical managementand rehabilitation. By the way, their prognosis in spite of active management was very poor. Patinets and Methods: From Aug, 2003 to Aug, 2005, 34 patients ( 28 male, 6 female) suffering complete spinal cord injury were included our clinical study. Patients suffering from traumatic spinal cord injury undertook decompressive surgery and stabilization through anterior approach, their clinical recovery above two weeks later was not noted, the authors applied autologous bone marrow stromal cell onto damaged spinal cord undergoing posterior laminectomy and GM-CSF also subcutaneously injected 5 cycles scheduled 5 consecutive days per month. Daily clinical results was meticulously recorded as . Also, MRI, f-MRI and EP were checked postoperatively. Results: Site of injury in 34 patients were recorded as 20 patients in the cervical spine, and 14 patients in the thoracic spine. Mean preoperative ASIA grade for all patients was A, however, clinical improvement of the 11 patients( 7 patients in ASIA C grade, 4 patients in ASIA B grade) was observed for the follow-up periods. Obviously, f-MRI change in which response in brain recorded as forced sensory stress in the foot were only observed in the patients showing clinical improvement. However, MEP and SSEP was not irregular. During follow-up periods, none have not been suffered from a significant side effect caused by stromal cell administration and GM-CSF infusion, exclusively fever, chilling and facial flushing. Conclusion: Major advantage of autologous bone marrow stromal cell and GM-CSF application in the complete spinal cord injury patients have favorably safety and less ethical problem, in spite of less potency of self-renewal power than other pluripotent stem cell.