Abstract

People with chronic and complete spinal cord injury have no expectations of functional recovery with conservative treatments. For this reason, without the risk of generating worsening and under the figure of compassionate use treatment, in 2016, we initiated a pilot program with autologous cell therapy combined with an intensive and multidisciplinary rehabilitation program in people suffering from a chronic (2 years or more post-injury) and complete (no sensitivity or voluntary muscular movements two levels below the lesion) spinal cord injury of traumatic origin.

Cell therapy aims to repair damaged spinal cord tissue and improve the condition of atrophic skeletal muscles resulting from denervation and lack of movement. For this purpose, mesenchymal stem cells derived from fat tissue and tissue-specific effector lymphocytes were used. The neural progenitor cells were applied systemically (intravenous infusion), and the muscular progenitor cells were applied by ultrasound-guided puncture. Each patient received between 15 and 30 applications during the seven years of follow-up.

Between February 2016 and February 2024, 20 patients underwent this program. All of them showed good tolerance with no moderate or severe adverse events associated with the application of the cells.

Significant changes in muscle ultrasound and electrophysiological parameters (electromyogram and somatosensory evoked potentials) were observed. 60% of the patients presented significant functional improvement (trunk balance, new movements, gate recovery) it was always associated with a specific and intensive rehabilitation plan aimed at inhibiting compensations and activating the areas affected by the lesion. 40% of the patients showed sphincter changes.

Although it is still too early to draw definitive conclusions, we can say that autologous cell treatment is well tolerated, that results between patients are highly variable, and that the positive changes observed are slow but progressive in onset and persist over time.