An attempt to treat patients who have injured spinal cords with intralesional implantation of concentrated autologous bone marrow cells.
OBJECTIVE
Spinal cord injury is common among young subjects involved in motor vehicle accidents. Mechanisms and attempts to reverse post-traumatic pathophysiologic consequences are still being investigated. Unfortunately no effective and well-established treatment modality has been developed so far. The regeneration capability of the human nervous system following an injury is highly limited.


METHODS
The study involved four patients (two male, two female) who had suffered spinal cord injury as a result of various types of trauma. On neurologic examination, all the patients were determined to be in American Spinal Injury Association (ASIA) grade A. All patients were treated with decompression, stabilization and fusion for vertebral trauma anteriorly, as well as intralesional implantation of cellular bone marrow concentrates using a posterior approach 1 month after the first operation. The patients were then treated and followed-up in the physical rehabilitation clinic.


RESULTS
At the end of the post-operative 1-year follow-up, two of the patients were classified as ASIA C while one was classified as ASIA B. One patient showed no neurologic change; none of the patients suffered from any complications or adverse effects as a result of intralesional application of bone marrow cells.


CONCLUSIONS
The results of this experimental study show the potential contribution of intralesional implantation of bone marrow to neuronal regeneration in the injured spinal cord, with neuronal changes. In light of the results of this experimental study, the potential for regenerative treatment in injuries of the human spinal cord is no longer a speculation but an observation.
Attar
Ayhan
A
Department of Neurosurgery, Ankara University, School of Medicine, Ankara, Turkey.
Ayten
Murat
M
Ozdemir
Mevci
M
Ozgencil
Enver
E
Bozkurt
Melih
M
Kaptanoglu
Erkan
E
Beksac
Meral
M
Kanpolat
Yucel
Y
D000328:Adult; D001854:Bone Marrow Cells / Q000166:cytology*; D016026:Bone Marrow Transplantation; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D055815:Young Adult