Copyright
©The Author(s) 2021.
World J Stem Cells. Feb 26, 2021; 13(2): 168-176
Published online Feb 26, 2021. doi: 10.4252/wjsc.v13.i2.168
Published online Feb 26, 2021. doi: 10.4252/wjsc.v13.i2.168
Ref. | Patients | n | Technical description | Outcomes |
Levi et al[17], 2019 | Chronic C-SCI patients | 12 | Perilesional intramedullary injection of human CNS-SCs using a two-hand stabilization technique | UEMS showed an increase in treatment group compared to control untreated SCI patients (2.8 points in 9 mo) |
Curtis et al[11], 2018 | Chronic T-SCI | 4 | Instrumentation removal, laminectomy, durotomy and stereotactic injection-using a floating cannula of spinal cord-derived neural stem cells | ISNCSCI improvement in 2 subjects with no adverse events |
Levi et al[8], 2018 | Chronic C/T-SCI | 29 | Free-hand intramedullary injection of human CNS-SCs | 13/29 patients experienced adverse events, all resolved by 3 mo |
Xiao et al[12], 2018 | Acute C/T-SCI | 2 | SCI injury site confirmed as complete and excised, collagen scaffold with hUC-MSCs transplanted as a bridge across injury site | Both patients improved from ASIA A → ASIA C |
Vaquero et al[27], 2018 | Chronic SCI patients | 9 | Three intrathecal injections of 100 × 106 MSCs | 44% patients increased voluntary muscle contraction and 66% improved in bladder compliance with no adverse effects |
Anderson et al[25], 2017 | Subacute T-SCI | 6 | U/S + MRI used for navigation. Table mount (Geron Corp) and Hamilton syringe used for intramedullary microinjection of sural nerve-derived SCs | No major adverse events and no consistent improvement in ISNCSCI |
Vaquero et al[18], 2017 | Chronic incomplete C/T/L SCI | 12 | Subarachnoid administration via lumbar puncture of autologous MSCs | Sexual function (2/8), spasticity (3/9) and bowel/bladder function improved (8/9) improvements were noted |
Vaquero et al[28], 2016 | Chronic complete C/T/L SCI | 12 | Subarachnoid administration via lumbar puncture of autologous MSCs | All patients experienced improvement in sensation and sphincter control. Motor activity below the lesion obtained in 50% of patients |
Satti et al[29], 2016 | Chronic and subacute T-SCI | 6 | Intrathecal injection of autologous MSCs | Evaluated safety only-no adverse events |
Bansal et al[22], 2016 | SCI patients | 8 | Lumbar puncture at L1/L2 with autologous BMSCs injected 3 times every 4 wk | Patients with injury less than 6 mo improved-ASIA grade improvement in 6/10, walking with support restored in 8/10 |
Hur et al[21], 2016 | Subacute to chronic C/T/L-SCI | 14 | Intrathecal injection through lumbar tap of 9 × 107 ADMSC | ASIA motor improved in ⅝ patients. 4 adverse events included headache and UTI |
Oh et al[10], 2016 | Chronic C-SCI | 16 | Laminectomy and durotomy with 1.6 × 107 BM-MSCs in 1 mL injected intramedullary with a 27 gauge needle. Fibrin glue used to prevent cell leakage. 3.2 × 107 BM-MSCs injected into the subdural space | 12.5% of patients with significant motor improvement |
Shin et al[20], 2015 | Acute/subacute C- SCI | 15 | Human fetal tissue-derived neural stem cell progenitor cells free hand injection 5 mm deep into lesion site | 5/19 in the treatment group with improved ASIA grade, compared to 1/15 in the control group with ASIA improvement |
Mendonça et al[19], 2014 | Chronic T/L-SCI | 14 | BM-MSCs injected based on lesion volume. Direct injection above and below level | 8/14 developed lower limb functional gain in hip flexors. 7/14 improved ASIA grades to B/C 9/14 with improved urologic function |
Cheng et al[30], 2014 | Chronic T/L-SCI | 10 | CT-guided intramedullary injection at the lesion site using purified UC-MSCs. Two transplantations separated by 10 d, each transplantation with 3 separate injections of 2 × 107 cells | 7/10 patients had significant improvement in movement and muscle tension |
Al-Zoubi et al[31], 2014 | Chronic T-SCI | 19 | Autologous purified CD34+/CD133+ SCs injected into cyst cavity or subarachnoid space | 7/19 patients with segmental sensory improvement, 2/19 with motor improvement (ASIA-A → ASIA-C) |
Yoon et al[23], 2014 | Acute/subacute/chronic C-SCI | 25 | Intramedullary perilesional injection of 2 × 108 BMCs in 6 locations + 5 cycles of GM-CSF Subq | ASIA grade increased in 30.4% of acute and subacute treated patients with no improvement in chronic treatment group |
Dai et al[32], 2013 | Chronic complete C-SCI | 20 | BMMSC transplantation at site of injury with MIS-laminectomy, dural incision and injection at a depth of 3 mm at central dorsal aspect of the junction between the lesioned and normal spinal cord. | 10/20 in BMMSC transplantation group had improvement in motor, light touch and pinprick sensory with 9/20 showing ASIA improvement. No improvement in any control patients (0/20) |
Park et al[9], 2012 | Traumatic C-SCI | 10 | Laminectomy and durotomy with 8 × 106 MSCs in 1 mL injected intramedullary over 10 s with a 26.5 gauge needle. Fibrin glue used to prevent cell leakage. At 4-8 wks post-op additional 5 × 107 MSCs injected via lumbar tap | 6/10 patients with motor power improvement of UE |
Frolov et al[33], 2012 | Chronic C-SCI | 20 | Repeated intrathecal autologous HSCs (from leukapheresis) repeatedly injected over 1 yr | 3-4 patients with improved SEP and MEP |
Karamouzian et al[24], 2012 | Acute/subacute T-SCI | 11 | Purified BM-MSC injected via standard lumbar puncture needle | 5/11 in BM-MSC treatment group had two grade improvement in ASIA score (i.e. A → C) compared to 3/20 in control group (P = 0.09) |
Ra et al[34], 2011 | Chronic SCI | 8 | IV administration of human ADMSCs | Safe with no adverse events related to transplantation at 3 mo |
Lima et al[14], 2009 | Chronic C/T SCI | 20 | Laminectomy with partial scar excision and olfactory mucosal autograft placement. Rehabilitation focused on lower extremity stepping continued post-operatively | 11/20 patients had ASIA improvement (6A → C, 3B → C, 2A → B) with 1/20 having ASIA decline (B → A). 15/20 with new voluntary EMG |
Cristante et al[35], 2009 | Chronic C/T-SCI | 39 | Apheresis for isolation of CD34+ bone marrow mononuclear stem cells-injected endovascularly via intercostal arteries or vertebral arteries | 26/39 patients showed recovery of SSEP to peripheral stimuli |
Pal et al[36], 2009 | Subacute to Chronic C/T SCI | 30 | BM-MSC expanded ex-vivo and injected via LP | Injection safe with no adverse events |
Mackay-Sim et al[37], 2008 | Chronic complete T-SCI | 6 | Nasal biopsy for isolation of OESC, cultured for 4-10 wks. Laminectomy, durotomy and injection into damaged spinal cord and proximal/distal ends of lesion with a table mounted stereotactic injection apparatus | No adverse events, 1 of 6 patients with an improvement of 3 segments in LT/PP |
Chernykh et al[38], 2007 | Chronic C/T/L SCI | 18 | Purified BM-MSCs injected into the cystic lesion cavity and given intravenously | Motor and sensory improvement was equivocal, spasticity was significantly improved by BM-MSC injection |
Lima et al[13], 2006 | Chronic C/T-SCI | 7 | Laminectomy, with scar excision with suturing graft loaded with olfactory tissue to meninges/superficial tissue layers | 2 patients went from ASIA-A to ASIA-C (out of 7 total) with return of bladder sensation/VAC |
Callera et al[39], 2006 | Chronic SCI | 10 | BM-MSCs injected via LP | Injection safe with no adverse events |
- Citation: Upadhyayula PS, Martin JR, Rennert RC, Ciacci JD. Review of operative considerations in spinal cord stem cell therapy. World J Stem Cells 2021; 13(2): 168-176
- URL: https://www.wjgnet.com/1948-0210/full/v13/i2/168.htm
- DOI: https://dx.doi.org/10.4252/wjsc.v13.i2.168