Safety of intramedullary Schwann cell transplantation for postrehabilitation spinal cord injuries: 2-year follow-up of 33 cases

2011 ◽  
Vol 15 (5) ◽  
pp. 515-525 ◽  
Author(s):  
Hooshang Saberi ◽  
Masoumeh Firouzi ◽  
Zohreh Habibi ◽  
Pouria Moshayedi ◽  
Hamid Reza Aghayan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Mr Imaging ◽  
Schwann Cell ◽  
Cell Transplantation ◽  
Spinal Cord Injuries ◽  
Experimental Studies ◽  
Functional Independence ◽  
Tumor Formation ◽  
Imaging Studies

Object Many experimental studies on spinal cord injuries (SCIs) support behavioral improvement after Schwann cell treatment. This study was conducted to evaluate safety issues 2 years after intramedullary Schwann cell transplantation in 33 consecutively selected patients with SCI. Methods Of 356 patients with SCIs who had completed at least 6 months of a conventional rehabilitation program and who were screened for the study criteria, 33 were enrolled. After giving their informed consent, they volunteered for participation. They underwent sural nerve harvesting and intramedullary injection of a processed Schwann cell solution. Outcome assessments included a general health questionnaire, neurological examination, and functional recordings in terms of American Spinal Injury Association (ASIA) and Functional Independence Measure scoring, which were documented by independent observers. There were 24 patients with thoracic and 9 with cervical injuries. Sixteen patients were categorized in ASIA Grade A, and the 17 remaining participants had ASIA Grade B. Results There were no cases of deep infection, and the follow-up MR imaging studies obtained at 2 years did not reveal any deformity related to the procedure. There was no case of permanent neurological worsening or any infectious or viral complications. No new increment in syrinx size or abnormal tissue and/or tumor formation were observed on contrast-enhanced MR imaging studies performed 2 years after the treatment. Conclusions Preliminary results, especially in terms of safety, seem to be promising, paving the way for future cell therapy trials.

Preliminary Results of Schwann Cell Transplantation for Chronic Spinal Cord Injuries

Neurosurgery ◽  
2006 ◽  
Vol 59 (2) ◽  
pp. 462 ◽  
Author(s):  
Hooshang Saberi ◽  
Maasoome Firoozi ◽  
Pooria Moshayedi
Keyword(s):  
Spinal Cord ◽  
Schwann Cell ◽  
Cell Transplantation ◽  
Spinal Cord Injuries ◽  
Preliminary Results

scholarly journals The efficacy of Schwann cell transplantation on motor function recovery after spinal cord injuries in animal models: A systematic review and meta-analysis

2016 ◽  
Vol 78 ◽  
pp. 102-111 ◽  
Author(s):  
Mostafa Hosseini ◽  
Mahmoud Yousefifard ◽  
Masoud Baikpour ◽  
Vafa Rahimi-Movaghar ◽  
Farinaz Nasirinezhad ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Animal Models ◽  
Schwann Cell ◽  
Cell Transplantation ◽  
Motor Function ◽  
Spinal Cord Injuries ◽  
Meta Analysis ◽  
Function Recovery

scholarly journals Classifications Used in Spinal Cord Injuries

2021 ◽  
Author(s):  
Erek Öztürk ◽  
Yener Akyuva ◽  
Erdinç Çivelek
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Functional Independence ◽  
International Standards ◽  
Data Set ◽  
Multidimensional Pain Inventory ◽  
Cord Injury

Creating a common language allows information to be shared well/wholesome/healthily. Classifications have a important role in the formation of this language, which provides many benefits such as follow-up of the clinical course. Classifications in spinal cord injuries are based on examination, so the results of different treatments can be revealed more clearly with a standardized examination and registration. The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) which is the most sensitive and common classification was developed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS), although its foundations were laid in 1969 by Frankel. Apart from neurological evaluation, there are scales such as Functional Independence Scale, Modified Barthel Index, Spinal Cord Independence Scale, Quadriplegia Functional Index, Walking Index for Spinal Cord Injury, Spinal Cord Injury Functional Ambulation Inventory to determine the functional status in spinal cord injuries. Additionally scales such as Assessment of Spinal Cord Injury Basic Pain Data Set, Multidimensional Pain Inventory, DN4 (DouleurNeuropathique DN4) can be used for pain assessment in a patient with spinal cord injury.

Preliminary Results of Schwann Cell Transplantation for Chronic Spinal Cord Injuries

Neurosurgery ◽  
2008 ◽  
Vol 62 (6) ◽  
pp. 1410 ◽  
Author(s):  
Hooshang Saberi ◽  
Maasoumeh Firoozi ◽  
Pooria Moshayedi ◽  
Hamidreza Aghayan ◽  
Babak Arjomand ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Schwann Cell ◽  
Cell Transplantation ◽  
Spinal Cord Injuries ◽  
Preliminary Results

Impairment Rating and Spinal Cord Injuries: Revisiting the Guides

2010 ◽  
Vol 15 (3) ◽  
pp. 1-7
Author(s):  
Richard T. Katz
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Functional Independence ◽  
Outcome Data ◽  
Multiple Organ ◽  
Loss Of Function ◽  
Sixth Edition ◽  
Organ Systems ◽  
Cord Injury ◽  
Impairment Ratings

Abstract This article addresses some criticisms of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) by comparing previously published outcome data from a group of complete spinal cord injury (SCI) persons with impairment ratings for a corresponding level of injury calculated using the AMA Guides, Sixth Edition. Results of the comparison show that impairment ratings using the sixth edition scale poorly with the level of impairments of activities of daily living (ADL) in SCI patients as assessed by the Functional Independence Measure (FIM) motor scale and the extended FIM motor scale. Because of the combinations of multiple impairments, the AMA Guides potentially overrates the impairment of paraplegics compared with that of quadriplegics. The use and applicability of the Combined Values formula should be further investigated, and complete loss of function of two upper extremities seems consistent with levels of quadriplegia using the SCI model. Some aspects of the AMA Guides contain inconsistencies. The concept of diminishing impairment values is not easily translated between specific losses of function per organ system and “overall” loss of ADLs involving multiple organ systems, and the notion of “catastrophic thresholds” involving multiple organ systems may support the understanding that variations in rating may exist in higher rating cases such as those that involve an SCI.

The Use of Cell Transplantation in Spinal Cord Injuries

2016 ◽  
Vol 24 (4) ◽  
pp. 266-275 ◽  
Author(s):  
Gregory D. Schroeder ◽  
Christopher K. Kepler ◽  
Alexander R. Vaccaro
Keyword(s):  
Spinal Cord ◽  
Cell Transplantation ◽  
Spinal Cord Injuries

MR imaging of ventriculus terminalis of the conus medullaris: A report of two operated patients and review of the literature

2003 ◽  
Vol 44 (4) ◽  
pp. 444-446
Author(s):  
R. Dullerud ◽  
A. Server ◽  
J. Berg-Johnsen
Keyword(s):  
Spinal Cord ◽  
Mr Imaging ◽  
Signal Intensity ◽  
Incidental Finding ◽  
Conus Medullaris ◽  
Review Of The Literature ◽  
Per Se ◽  
Specific Symptoms ◽  
Work Up

We report on 2 patients in whom a cystic dilation of the conus medullaris was incidentally found at MR imaging carried out in the work-up for sciatica. The cysts were well circumscribed and had signal intensity identical to the CSF on both T1- and T2-weighted images. There was no evidence of contrast enhancement. None of the patients had specific symptoms related to the spinal cord. At surgery, no evidence of malignancy was seen in any of the patients. A benign cystic dilation, also called dilated ventriculus terminalis, occasionally can be seen in the conus medullaris as an incidental finding at thoracolumbar MR imaging. Unless the expansion per se indicates cyst drainage, these patients may be monitored by clinical and MR follow-up, avoiding surgery in a substantial number of cases.

scholarly journals A complex case of neuro-muscular rehabilitation with favorable evolution, in a patient with incomplete tetraplegia post cervical and thoracic spinal cord injury - surgically treated, in a politraumatic context, by car accident

2020 ◽  
pp. 524-526
Author(s):  
Andreea DUMITRASCU ◽  
Ioana ANDONE ◽  
Aura SPÎNU ◽  
Carmen CHIPĂRUȘ ◽  
Cristina POPESCU ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Functional Independence ◽  
Complex Case ◽  
Urinary Catheterization ◽  
Functional Evaluation ◽  
Thoracic Spinal Cord ◽  
Cord Injury ◽  
Car Accident

Introduction: Spinal cord injuries (SCI) are major conditions that usually determine severe and permanent dysfunctions, or even important loss of basic functions, generating severe or rather permanent sequels. They can have important chronic consequences such as: tetraplegia or paraplegia.(1). Materials and Methods: This paper presents the case of a young 19-year-old patient who suffered in March 2019, a car accident (passenger) with spinal cord injury (SCI) at cervical and thoracic level in a politraumatic context, hospitalized at the Neurosurgery Clinic (NS) II of TEHBA in a severe condition, for complete AIS/Frankel A tetraplegia, with a C7 fracture, T3, T4, T5 cominutive fractures with fragments in the medullary channel, minor traumatic brain injury, multiple costal fractures, abdominal trauma and respiratory failure. When the patient became hemodynamic and respiratory stable it was decided a neuro-surgical intervention, initially at cervical level through an anterior approach, with mixed osteo-sinthesis and C7 discectomy. Because of the spine instability, thoracic surgical treatment was delayed with 11 days, when he suffers a neurosurgery for medullary decompression, drainage and stabilization of the spine. In our clinical division, the patient was admitted with an incomplete AIS/Frankel B tetraplegia and initially followed a rehabilitation nursing program and subsequently continued with a recovery therapy according to clinical stages. The patient was assessed functionally using the following scales: AIS/Frankel, modified Ashworth, Functional Independence Measure (FIM), Life Quality Assessment (QOL), FAC International Scale, Independence Assessment Scale in Daily Activities (ADL / IADL), Walking Scale for Spinal Cord Injury (WISCI). Results: The patient benefited from a complex neuro-muscular rehabilitation program, having a favorable evolution, with an increase in the evaluated scales scores – passing from AIS/Frankel B classification to a severe AIS/Frankel C stage, and thus, at the moment he is performing walking on short distances, through parallel bars, with long left leg orthosis and support from another person. It was tried a sphincter re-education, but, after urologic examination, because of the important spasticity in the lower limbs and of the urinary catheterization discomfort, it was decided that for a while the patient to remain with fixed urinary catheterization. Conclusions: Even if there is still no cure for SCI sequels, the accurate clinical-functional evaluation, the neurosurgical prompt therapeutic approach, adding complex nursing measures, personalized rehabilitative and kinetotherapy programs, in a young patient with SCI by car accident, determined neuro-locomotor improvements with an increase in patient’s quality of life.(1),(2). Keywords: spinal cord injuries, tetraplegia, traumatism, rehabilitation,

Physical Activity, Quality of Life, and Functional Autonomy of Adults With Spinal Cord Injuries

2013 ◽  
Vol 30 (4) ◽  
pp. 317-337 ◽  
Author(s):  
Camilla Yuri Kawanishi ◽  
Márcia Greguol
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Functional Independence ◽  
Cord Injury ◽  
Functional Autonomy ◽  
Using Data

This study aimed to perform a systematic review of studies that address the influence of physical activity on the quality of life and functional independence of adult individuals with spinal cord injury. The review was performed using data obtained from the MEDLINE, CINAHL, SciELO, LILACS, SPORTDiscus, Web of Science, Academic Search Premier, and PEDro databases using the following keywords: quality of life; functional independence; autonomy; independence; physical activity; activities of daily living; physical exercise; tetraplegia; paraplegia; spinal cord injury; physical disabilities; and wheelchair. Eleven studies met the inclusion criteria. Although there was a lack of consensus among the selected studies, the majority of them presented a strong correlation between physical activity and variables of quality of life and/or functional independence. Thus, physical activity appears to have an important influence on social relationships, functional independence, psychological factors, and physical aspects, which can enhance quality of life and independence in the performance of daily activities.

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