The Efficacy of Intralesional Transplantation of Autologous Bone Marrow Mesenchymal Stem Cells in Patients with Traumatic Complete Spinal Cord Injury at Dorsal Spine

Background: Spinal cord injury (SCI) constitutes an individual, social, and economic devastating problem.
Objective: This investigation aimed to assess the safety and prospective benefits of intralesional transplantation of autologous bone marrow mesenchymal stem cells(MSCs) as a treatment option for patients with traumatic complete SCI at the dorsal spine, where spontaneous recovery has been unsuccessful.
Patients and methods: 45 patients who had complete traumatic SCI at the dorsal spine were hospitalized at Al-Azhar University Hospital. They underwent intralesional transplantation of autologous MSCs after failure of natural repair as part of this prospective interventional trial. A complete neurological examination and routine laboratory and radiological investigations, including plain X-rays, CT, MRI of dorsal spines, EMGs, and NCVs, were performed for all patients to assess the level and completeness of the injury. ASIA impairment scale was used to evaluate the neurological state.
Results: All cases were initially classified as ASIA grade A, indicating complete spinal cord injury. The average injury duration was 16.04 ± 8.3 months. Mild neurological improvement was noticed in 4.5% who progressed to grade C, 33.3% to grade B, while 62.2% remained at grade A. Complications were minimal, with 8.9% experiencing allergic skin reactions. A significant inverse correlation was found between injury duration and clinical outcome, suggesting better recovery in patients with shorter injury durations.
Conclusion: Clinical outcome improvement was noticed in using intralesional transplantation of autologous MSCs as early as possible after failure of natural repair and before the occurrence of adhesive gliosis, which prevents the growth of axons and regeneration.