Introduction: Bone marrow is a readily accessible source for autologous adult bone marrow stem cells which can be applied therapeutically without possessing the risk of immune rejection and without raising ethical concerns. The purpose of this study is to determine the feasibility, safety, and effectiveness of direct transplantation of autologous adult bone marrow stem cells in patients with chronic cord injuries

Methods: Thirty consecutive patients (5 females and 25 males, aged 6-64 years) having chronic traumatic dorsal spinal cord injury with durations of at least 6 months were included in the study. Twenty patients were treated with autologous adult bone marrow stem cells transplantation via open surgical intraparenchymal and intralesional injection into the site of cord injury. The treatment was continued with monthly intrathecal injection of stem cells via lumbar or cisternal punctures. Ten other patients were not treated with stem cells and served as control cases

Results: Clinical improvement was observed in 6 (30%) out of 20 patients treated with stem cells transplantation. Short duration of injury and small cord lesions correlated with good outcome. Follow up electrophysiological studies did not show statistically significant changes. Follow up MRI did not show significant changes. Minor and temporary treatment-related morbidity were recorded

Conclusions: The application of autologous adult bone marrow mesenchymal stem cells directly into the spinal cord is relatively safe and has clinical benefits in patients with chronic spinal cord injury. However, multicenter studies should be conducted to further elucidate the safety and efficacy of stem cells therapy in patients with spinal cord injury

Patient Care: The results of the present research provide evidence for potential neuroregeneration and hence better rehabilitation and quality of life for patients with traumatic spinal cord injuries

Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of neuroregeneration in cases of traumatic spinal cord injuries, 2) Discuss, in small groups,the surgical procedure of stem cells transplantation, 3) Identify an effective treatment for spinal cord regeneration following traumatic injuries

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