Feasibility, Safety, and Efficacy of Directly Transplanting Autologous Adult Bone Marrow Stem Cells in Patients With Chronic Traumatic Dorsal Cord Injury A Pilot Clinical Study

Background: Bone marrow is a readily accessible source for autologous adult bone marrow stem cells which can be applied therapeutically without possessing the risk of immune rejection and without raising ethical concerns. The purpose of this study is to determine the feasibility, safety, and effectiveness of direct transplantation of autologous adult bone marrow stem cells in patients with chronic cord injuries. Methods: Thirty consecutive patients (5 females and 25 males, aged 6 to 64 y) having chronic traumatic dorsal spinal cord injury with durations of at least 6 months were included in the study. Twenty patients were treated with autologous adult bone marrow stem cells transplantation through open surgical intraparenchymal and intralesional injection into the site of cord injury. The treatment was continued with monthly intrathecal injection of stem cells through lumbar or cisternal punctures. Ten other patients were not treated with stem cells and served as control cases. Results: Clinical improvement was observed in 6 (30%) of 20 patients treated with stem cells transplantation. Short duration of injury and small cord lesions correlated with good outcome. Follow-up electrophysiologic studies did not show statistically significant changes. Follow-up magnetic resonance imaging did not show significant changes. Minor and temporary treatment-related morbidity were recorded. Conclusions: The application of autologous adult bone marrow mesenchymal stem cells directly into the spinal cord is relatively safe and has clinical benefits in patients with chronic spinal cord injury. However, multicenter studies should be conducted to further elucidate the safety and efficacy of stem cells therapy in patients with spinal cord injury.