Srivastava Rajeshwar Nath, Agrahari Ashok Kumar, Singh Alka, Chandra Tulika, Raj Saloni
Department of Orthopedic Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India.
Department of Transfusion Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
Asian J Transfus Sci. 2019 Jul-Dec;13(2):120-128. doi: 10.4103/ajts.AJTS_44_18. Epub 2019 Dec 3.
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.
This study was undertaken for evaluating the neurological status of acute SCI participants after stem cell augmentation and comparing them with other treatment methods.
Randomized controlled trial in the northern Indian population.
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.
-test for sensory-motor score analysis of each group and analysis of variance for comparison of same variables between the groups.
After 1-year significant difference was observed in the AIS-grade, sensory and motor scores in-Group 1 ( < 0.001). In Group-1 versus 2, the mean difference at 1 year for AIS grade, sensory and motor scores were 0.40 ( = 0.010, 95% confidence interval [CI] 0.075-0.727), 8.52 ( = 0.030, 95% CI 0.619-16.419), and 4.55( = 0.003, 95% CI 1.282-7.815), respectively. In Group-1 versus 3, 1.03, 19.02 and 7.22 ( < 0.001 for each of the parameters) and in Group-2 versus 3, 0.63 ( < 0.001), 10.49 ( = 0.009), and 2.68 ( = 0.019), respectively.
Significant motor neurological recovery and AIS-grade promotion was observed in Group-1 as compared to Group-2 and 3.
脊髓损伤（SCI）后的完全性损伤仍然不可逆转，神经功能恢复的希望渺茫。使用人工手段重新刺激受损神经元以及利用干细胞促进神经元再生等新的干预措施已显示出有前景的结果。
本研究旨在评估干细胞增强治疗后急性脊髓损伤参与者的神经状态，并将其与其他治疗方法进行比较。
在印度北部人群中进行的随机对照试验。
本研究纳入了193例胸腰段损伤严重程度评分≥4的完全性截瘫且T4-L2损伤不稳定的脊髓损伤参与者。参与者被随机分配到三种不同的治疗方式，即传统治疗加干细胞增强治疗（第1组）、传统治疗（第2组）和保守治疗（第3组）。通过美国脊髓损伤协会损伤量表（AIS）分级、感觉和运动评分评估1年后的神经功能恢复情况。
对每组的感觉运动评分进行t检验，对组间相同变量进行方差分析。
1年后，第1组的AIS分级、感觉和运动评分有显著差异（P<0.001）。在第1组与第2组之间，1年后AIS分级、感觉和运动评分的平均差异分别为0.40（P=0.010，95%置信区间[CI]0.075-0.727）、8.52（P=0.030，95%CI0.619-16.419）和4.55（P=0.003，95%CI1.282-7.815）。在第1组与第3组之间，差异分别为1.03、19.02和7.22（各参数P<0.001），在第2组与第3组之间，差异分别为0.63（P<0.001）、10.49（P=0.009）和2.68（P=0.019）。
与第2组和第3组相比，第1组观察到显著的运动神经功能恢复和AIS分级提升。
