Upadhyayula Pavan S, Martin Joel R, Rennert Robert C, Ciacci Joseph D
Department of Neurological Surgery, University of California, San Diego, La Jolla, CA 92037, United States.
World J Stem Cells. 2021 Feb 26;13(2):168-176. doi: 10.4252/wjsc.v13.i2.168.
Spinal cord injury (SCI) can permanently impair motor and sensory function and has a devastating cost to patients and the United States healthcare system. Stem cell transplantation for treatment of SCI is a new technique aimed at creating biological functional recovery. Operative techniques in stem cell transplantation for SCI are varied. We review various clinical treatment paradigms, surgical techniques and technical considerations important in SCI treatment. The NCBI PubMed database was queried for "SCI" and "stem cell" with a filter placed for "clinical trials". Thirty-nine articles resulted from the search and 29 were included and evaluated by study authors. A total of 10 articles were excluded (9 not SCI focused or transplantation focused, 1 canine model). Key considerations for stem cell transplantation include method of delivery (intravenous, intrathecal, intramedullary, or excision and engraftment), time course of treatment, number of treatments and time from injury until treatment. There are no phase III clinical trials yet, but decreased time from injury to treatment and a greater number of stem cell injections both seem to increase the chance of functional recovery.
脊髓损伤（SCI）会永久性损害运动和感觉功能，给患者及美国医疗系统带来巨大损失。干细胞移植治疗SCI是一项旨在实现生物功能恢复的新技术。SCI干细胞移植的手术技术多种多样。我们回顾了各种临床治疗模式、手术技术以及SCI治疗中重要的技术考量因素。通过在NCBI PubMed数据库中检索“SCI”和“干细胞”，并设置“临床试验”过滤器。检索结果有39篇文章，研究作者纳入并评估了其中29篇。总共排除了10篇文章（9篇未聚焦于SCI或移植，1篇为犬类模型）。干细胞移植的关键考量因素包括给药方式（静脉注射、鞘内注射、髓内注射或切除并植入）、治疗时间进程、治疗次数以及受伤至治疗的时间。目前尚无III期临床试验，但缩短受伤至治疗的时间以及增加干细胞注射次数似乎都能提高功能恢复的几率。
