Iwatsuki Koichi, Tajima Fumihiro, Sankai Yoshiyuki, Ohnishi Yu-Ichiro, Nakamura Takeshi, Ishihara Masahiro, Hosomi Koichi, Ninomiya Koshi, Moriwaki Takashi, Yoshimine Toshiki
Department of Neurosurgery, Osaka University Medical School , Osaka, Japan.
Department of Rehabilitation Medicine, Wakayama Medical University , Wakayama, Japan.
Spinal Cord Ser Cases. 2016 Jan 7;2:15018. doi: 10.1038/scsandc.2015.18. eCollection 2016.
The efficacy of olfactory mucosal autografts (OMAs) for chronic spinal cord injury (SCI) has been reported, but there is no report documenting electrophysiological conductivity via the emergence of motor evoked potentials (MEPs). We report the case of a 39-year-old man with chronic, complete SCI at T8, who exhibited MEPs after OMA transplantation, and, with intensive rehabilitation, was ultimately able to ambulate with short leg braces and Lofstrand crutches. The initial injury occurred in a motor vehicle accident in November 1999 and resulted in a complete loss of sensorimotor function below T8. OMA transplantation to the injury site was performed in March 2010 in combination with intensive pre- and postoperative rehabilitation. The patient exhibited voluntary electromyograph (EMG) activity and MEPs at 96 and 144 weeks after transplantation and he was was ambulatory with short leg braces and Lofstrand crutches at 144 weeks after transplantation. We were able to elicit MEPs after OMA with intensive rehabilitation. To our knowledge, this is the first report of recovery of electrophysiological conductivity in the spinal cord after any type of treatment for chronic, complete SCI.
嗅黏膜自体移植术（OMA）对慢性脊髓损伤（SCI）的疗效已有报道，但尚无文献记录通过运动诱发电位（MEP）的出现来证明其电生理传导性。我们报告了一例39岁男性，T8水平慢性完全性脊髓损伤，OMA移植后出现了MEP，经过强化康复训练，最终能够借助短腿支具和洛弗斯特兰德拐杖行走。最初的损伤发生在1999年11月的一起机动车事故中，导致T8以下感觉运动功能完全丧失。2010年3月对损伤部位进行了OMA移植，并结合了术前和术后的强化康复训练。患者在移植后96周和144周出现了自主肌电图（EMG）活动和MEP，在移植后144周能够借助短腿支具和洛弗斯特兰德拐杖行走。经过强化康复训练，OMA移植后我们能够引出MEP。据我们所知，这是第一例关于慢性完全性脊髓损伤经过任何类型治疗后脊髓电生理传导性恢复的报告。
