Document Detail


Biological modalities for treatment of acute spinal cord injury: a pilot study and review of the literature.
MedLine Citation:
PMID:  24889979     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objective: Paraplegia due to traumatic spinal cord injuries is one of the devastating effects of dorsolumbar vertebral fractures. Treatment modalities for such fractures, such as stabilization, have no effect on the neurological recovery. Thus, various pharmacological and biological treatment modalities have been used. The more recent trend of using autologous stem cells from the iliac crest has been used in some clinical trials with varying success. Thus, more clinical studies are required to study the effect of this novel approach Methods: This is a prospective hospital-based cohort study (level IV). The study was conducted in the Dept. of Orthopaedics, University College of Medical Sciences and GTB Hospital, Delhi from November 2010 to March 2012. Ten patients who had sustained traumatic dorsolumbar vertebral fractures with complete paraplegia were recruited for this study. Under suitable anaesthesia, at the beginning of surgery, 100 ml of bone marrow was aspirated. This was centrifuged and buffy coat isolated and then transferred into a sterile tube and sent to the operating room on ice packs. After surgical decompression and stabilization, the buffy coat isolate was injected into the dural sleeve at the site of the injury using a 21G needle. All the patients were evaluated for neurological improvement using the American Spinal Injury Association (ASIA) score and Frankel grade at 6 weeks and 3 months postoperatively. Results: The evaluation at 6 weeks showed some improvement in terms of the ASIA scores in 2 patients but no improvements in their Frankel Grade. The other 8 patients showed no improvements in their ASIA scores or their Frankel Grades. The current pilot study has shown that there has been no improvement in most of the recipients of the transplant (n=8). Some patients (n=2) who did show some improvement in their sensory scores proved to be of no significant functional value as depicted by no change in their Frankel Grades. Conclusion: The outcome of current study shows that although this modality of treatment is safe for the patients, it provides no additional benefits on improvement of quality of life among these patients.
Authors:
Kutbuddin Akbary; Shobha-S Arora
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chinese journal of traumatology = Zhonghua chuang shang za zhi / Chinese Medical Association     Volume:  17     ISSN:  1008-1275     ISO Abbreviation:  Chin. J. Traumatol.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-06-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886162     Medline TA:  Chin J Traumatol     Country:  China    
Other Details:
Languages:  eng     Pagination:  157-64     Citation Subset:  IM    
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