Original Article

Spinal Cord advance online publication 2 June 2009; doi: 10.1038/sc.2009.54

Autologous mucosal transplant in chronic spinal cord injury: an Indian Pilot Study

H S Chhabra1, C Lima2, S Sachdeva3, A Mittal4, V Nigam1, D Chaturvedi5, M Arora6,7, A Aggarwal8, R Kapur9 and T A H Khan1

  1. 1Spine Service, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, India
  2. 2Neuropathology Laboratory, Department of Neurology, Hospital de Egas Moniz, Lisbon, Portugal
  3. 3Departmet of ENT Surgery, Fortis Hospital, Noida, Uttar Pradesh, India
  4. 4Department of ENT Surgery, Modi Hospital, Saket, New Delhi, India
  5. 5Department of Neurosurgery, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, India
  6. 6Research Department, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, India
  7. 7Rehabilitation Department, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, India
  8. 8Department of Radiology, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, India
  9. 9Department of Radiology, Goyal MRI and Imaging Centre, Safdarjung Enclave, New Delhi, India

Correspondence: Dr HS Chhabra, Spine Service, Indian Spinal Injuries Center, Vasant Kunj Sector-C, New Delhi 110070, India. E-mails: drhschhabra@isiconline.org, issicon@isiconline.org

Received 13 October 2008; Revised 23 March 2009; Accepted 8 April 2009; Published online 2 June 2009.

Top

Abstract

Study design:

 

Prospective Pilot Study.

Objectives:

 

To determine the safety and feasibility of autologous olfactory mucosal transplantation into the spinal cord in chronic spinal cord injured using the technique developed by Carlos Lima et al.

Setting:

 

Spinal Injury Center, New Delhi.

Methods:

 

Five chronic, motor complete, traumatic spinal cord injury (SCI) patients with neurological level C5–T12 underwent the procedure. Participants were assessed at baseline and at 6 monthly intervals. Safety and tolerability were evaluated through monitoring for any adverse events and tests including magnetic resonance imaging (MRI) evaluation. Efficacy assessment was done through neurological, functional and psychological evaluation, electrophysiological studies and urodynamics.

Results:

 

Surgery was tolerated well by all American Spinal Injury Association (ASIA) Impairment Scale (AIS) A participants. The only AIS B participant lost sensory scores significantly after surgery but is gradually regaining it. MRI evaluation revealed a syrinx in one participant and increase in length of myelomalacia in four participants. There were no other adverse findings on MRI evaluation. There was no significant improvement in any of the neurological, electrophysiological or urodynamic efficacy variables. Statistically significant improvement was seen in functional scores as evaluated by Spinal Cord Independence Measure, Beck Depression Inventory scores and life impact scores on International Spinal Cord Injury Scale.

Conclusions:

 

The procedure is relatively safe and feasible in AIS A participants with thoracic level injuries at 18 month follow-up. No efficacy could be demonstrated which could be attributed to the procedure.

Keywords:

spinal cord injury, chronic, human trial, autologous mucosal transplantation

Extra navigation

.
ADVERTISEMENT