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. 2019 Jul-Dec;13(2):120-128.
doi: 10.4103/ajts.AJTS_44_18. Epub 2019 Dec 3.

Effectiveness of bone marrow-derived mononuclear stem cells for neurological recovery in participants with spinal cord injury: A randomized controlled trial

Rajeshwar Nath Srivastava  1 , Ashok Kumar Agrahari  1 , Alka Singh  1 , Tulika Chandra  2 , Saloni Raj  1
Affiliations

Effectiveness of bone marrow-derived mononuclear stem cells for neurological recovery in participants with spinal cord injury: A randomized controlled trial

Rajeshwar Nath Srivastava et al. Asian J Transfus Sci. 2019 Jul-Dec.

Abstract

Background: Complete lesion after spinal cord injury (SCI) remains irreversible with little hope of neurological recovery. Newer interventions such as re-stimulation of damaged neurons using artificial agents and the use of stem cells for neuronal regeneration have shown promising results.

Aim: This study was undertaken for evaluating the neurological status of acute SCI participants after stem cell augmentation and comparing them with other treatment methods.

Setting and design: Randomized controlled trial in the northern Indian population.

Materials and methods: A total 193 SCI participants of complete paraplegia with unstable T4-L2 injury having thoracolumbar injury severity score ≥4 were enrolled in this study. Participants were randomly allocated for three different treatment modalities, namely, conventional with stem cell augmentation (Group-1), conventional (Group-2), and conservative (Group-3). Neurological recovery after 1 year was evaluated through the ASIA Impairment Scale (AIS)-grading, sensory, and motor scores.

Statistical analysis: T-test for sensory-motor score analysis of each group and analysis of variance for comparison of same variables between the groups.

Results: After 1-year significant difference was observed in the AIS-grade, sensory and motor scores in-Group 1 (P < 0.001). In Group-1 versus 2, the mean difference at 1 year for AIS grade, sensory and motor scores were 0.40 (P = 0.010, 95% confidence interval [CI] 0.075-0.727), 8.52 (P = 0.030, 95% CI 0.619-16.419), and 4.55(P = 0.003, 95% CI 1.282-7.815), respectively. In Group-1 versus 3, 1.03, 19.02 and 7.22 (P < 0.001 for each of the parameters) and in Group-2 versus 3, 0.63 (P < 0.001), 10.49 (P = 0.009), and 2.68 (P = 0.019), respectively.

Conclusions: Significant motor neurological recovery and AIS-grade promotion was observed in Group-1 as compared to Group-2 and 3.

Keywords: Acute spinal cord injury; autologous bone marrow mononuclear stem cells; conventional treatment; neurological recovery; thoracolumbar injury severity score.

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Conflict of interest statement

There are no conflicts of interest.

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