Publication: Chronic spinal cord injury treated with transplanted autologous bone marrow-derived mesenchymal stem cells tracked by magnetic resonance imaging: a case report
Issued Date
2015
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eng
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Mahidol University
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BioMed Central
Bibliographic Citation
Journal of Medical Case Reports. Vol. 9, (2015), 79
Suggested Citation
Areesak Chotivichit, Monchai Ruangchainikom, Pipat Chiewvit, Adisak Wongkajornsilp, Kittipong Sujirattanawimol Chronic spinal cord injury treated with transplanted autologous bone marrow-derived mesenchymal stem cells tracked by magnetic resonance imaging: a case report. Journal of Medical Case Reports. Vol. 9, (2015), 79. doi:10.1186/s13256-015-0535-6 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/2666
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Title
Chronic spinal cord injury treated with transplanted autologous bone marrow-derived mesenchymal stem cells tracked by magnetic resonance imaging: a case report
Abstract
Introduction: Intrathecal transplantation is a minimally invasive method for the delivery of stem cells, however,
whether the cells migrate from the lumbar to the injured cervical spinal cord has not been proved in humans. We
describe an attempt to track bone marrow-derived mesenchymal stem cells in a patient with a chronic cervical
spinal cord injury.
Case presentation: A 33-year-old Thai man who sustained an incomplete spinal cord injury from the atlanto-axial
subluxation was enrolled into a pilot study aiming to track bone marrow-derived mesenchymal stem cells, labeled
with superparamagnetic iron oxide nanoparticles, from intrathecal transplantation in chronic cervical spinal
cord injury. He had been dependent on respiratory support since 2005. There had been no improvement in his
neurological function for the past 54 months. Bone marrow-derived mesenchymal stem cells were retrieved
from his iliac crest and repopulated to the target number. One half of the total cells were labeled with superparamagnetic
iron oxide nanoparticles before transplantation to the intrathecal space between L4 and L5. Magnetic resonance imaging
studies were performed immediately after the transplantation and at 48 hours, two weeks, one month and seven months
after the transplantation. His magnetic resonance imaging scan performed immediately after the transplantation showed
hyposignal intensity of paramagnetic substance tagged stem cells in the subarachnoid space at the lumbar spine area.
This phenomenon was observed at the surface around his cervical spinal cord at 48 hours. A focal hyposignal intensity of
tagged bone marrow-derived stem cells was detected at his cervical spinal cord with magnetic resonance imaging at 48
hours, which faded after two weeks, and then disappeared after one month. No clinical improvement of the neurological
function had occurred at the end of this study. However, at 48 hours after the transplantation, he presented with a fever,
headache, myalgia and worsening of his motor function (by one grade of all key muscles by the American Spinal Injury
Association impairment scale), which lasted for 48 hours.
Conclusion: Intrathecal injection of bone marrow-derived stem cells at the lumbar spine level could deliver the cells to
the injured cervical spinal cord. Transient complications should be observed closely in the first 48 hours after transplantation.
Further study should be carried out to evaluate the result of the treatment.