Autologous Olfactory Lamina Propria Transplantation for Chronic Spinal Cord Injury: Three-Year Follow-Up Outcomes From a Prospective Double-Blinded Clinical Trial.
We did a clinical trial to determine whether olfactory mucosa lamina propria (OLP) transplants promote regeneration and functional recovery in chronic human spinal cord injury (SCI). The trial randomized 12 subjects to OLP transplants (n = 8) or control sham surgery (n = 4). The subjects received magnetic resonance imaging (MRI), electromyography (EMG), urodynamic study (UDS), American Spinal Injury Association impairment scale (AIS), and other functional assessments. OLP-transplanted subjects recovered more motor, sensory, and bladder function compared to sham-operated subjects. At 3 years after OLP transplant, one patient improved from AIS A to C and another recovered from AIS A to B, two recovered more than three segmental sensory levels, two had less spasticity, two had altered H-reflexes and SSEP, two regained bladder and anorectal sensation and had improved bladder compliance on UDS. OLP-treated patients had partial or complete tissue bridges at the injury site compared to cavitary gaps in sham-operated patients. The limited recovery suggests that OLP transplants alone do not have significant benefits but may provide a rationale for larger randomized trials or combination therapies.
Department of Spinal Surgery, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Sheng
S
Wang
Jike
J
Lu
Yu-An
YA
Li
Hui
H
Zhou
Wen-Fei
WF
Ni
Xiao-Lei
XL
Zhang
Si-Pin
SP
Zhu
Bo-Bei
BB
Chen
Hui
H
Xu
Xiang-Yang
XY
Wang
Jian
J
Xiao
Hongyun
H
Huang
Yong-Long
YL
Chi
Hua-Zi
HZ
Xu
D000328:Adult; D002908:Chronic Disease; D003710:Demography; D004311:Double-Blind Method; D004576:Electromyography; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009831:Olfactory Mucosa / Q000637:transplantation*; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy*; D014182:Transplantation, Autologous / Q000009:adverse effects; D016896:Treatment Outcome; D014563:Urodynamics; D055815:Young Adult