Introduction: Therapeutic cloning or the process of somatic cell nuclear transfer (SCNT) or therapeutic human cloning creates autologous embryos with no risk of rejection. We aimed to treat a chronic quadriplegic patient with embryonic stem cells created by SCNT.
Methods: The subject was a 32 year male patient who had been ASIA A at the level of C5 since March 2006 following a C5/6 bi-facet dislocation in a diving accident.
Clinically - Motor: right (3-/5 bicep function), left (2/5 shoulder abduction). Sensory: complete sensory level C4 bilaterally.
MRI – demonstrated a 3.3 cm spinal cord discontinuous defect filled with scar tissue.
Autologous embryonic stem cells (AESC) were created by SCNT in the weeks preceding surgery.
In October 2012 a cervical laminectomy, durotomy and lesionectomy was performed of the intervening scar tissue with neurophysiological monitoring to limit damage to viable tissue. AESC in a gelatin matrix was used to fill the defect. AESC were augmented and a fibrin matrix added 14 days later.
Since then the patient has undergone extensive daily spinal rehabilitation at an average of 17 hours of therapy per week.
Results: October 2013:
Motor function– motor activation in 16 new motor segments (C5 - L1) and increase in power and functionality of existing motor segments.
Sensation - accurate reproducible awareness of sensation up to L1 and non-accurate sensory awareness up to S5.
Electromyography - normal conduction in the arms bilaterally, conduction to femoral nerves bilaterally.
MRI scan evaluation (three, six and twelve months) - no infection, tumors or any complications were detected. Neural regrowth is unclear on conventional MRI.
Conclusions: Caution should be exercised in interpreting the results in a single patient. The chronicity of the SCI (ASIA A), complete spinal cord defect and the post-operative clinical and electrophysiological results gives cause for cautious optimism.
Patient Care: If the results are reproducible, this is a massive advance in the treatment of patients with spinal cord injuries.
Learning Objectives: Spinal cord injury is devastating, but new advances bring new hope in the management.