Motoric Recovery After Transplantation of Bone Marrow Derived Mesenchymal Stem Cells in Chronic Spinal Cord Injury: A Case Report
Unusual or unexpected effect of treatment
Phe Phedy, Yoshi P. Djaja, Luthfi Gatam, Yuyus Kusnadi, Rosiana P. Wirawan, Indriati M.S. Tobing, Nursanti Subakir, Arfan Mappalilu, Matheus A. Prawira, Rouna Yauwenas, Asrafi R. Gatam
(Department of Orthopaedic and Traumatology, Fatmawati Central General Hospital, Jakarta, Indonesia)
Am J Case Rep 2019; 20:1299-1304
For the past 20 years, numerous of clinical trials focusing on the use of mesenchymal stem cells (MSC) in spinal cord injury (SCI) treatment has been conducted. However, controversies over whether stem cells are the main factor in a patient’s recovery still persisted in sub-acute SCI. This study aimed to evaluate the motoric recovery in a chronic SCI patient treated with bone marrow derived MSC (BM-MSC) transplantation.
CASE REPORT: We present a case report of patient with a 12-year-long-chronic SCI that was treated by BM-MSC) transplantation using a serial administration protocol. The protocol consisted of direct parenchymal injection to the affected lesion and multiple (5 times) intravenous stem cell injection as the adjuncts. There was no complication or serious adverse effects encountered during the procedure and follow up. At the final follow up of 5 years, the patient neurological status improved from American Spinal Injury Association (ASIA) A status to ASIA C status, which signifies improvement in his ambulatory status. Magnetic resonance imaging and electrophysiology examination also showed changes that indicated recovery of the neurologic function.
CONCLUSIONS: Based on the limited adverse reaction and outcome, our case report may serve as an additional alternative protocol in stem cell administration to improve the outcome of chronic spinal cord injury patients.
Keywords: adult stem cells, Mesenchymal Stem Cell Transplantation, Spinal Cord Injuries