Published online Feb 26, 2021. doi: 10.4252/wjsc.v13.i2.168
Peer-review started: December 6, 2020
First decision: December 31, 2020
Revised: January 18, 2021
Accepted: February 12, 2021
Article in press: February 12, 2021
Published online: February 26, 2021
Processing time: 74 Days and 21.3 Hours
Spinal cord injury (SCI) can permanently impair motor and sensory function and has a devastating cost to patients and the United States healthcare system. Stem cell transplantation for treatment of SCI is a new technique aimed at creating biological functional recovery. Operative techniques in stem cell transplantation for SCI are varied. We review various clinical treatment paradigms, surgical techniques and technical considerations important in SCI treatment. The NCBI PubMed database was queried for “SCI” and “stem cell” with a filter placed for “clinical trials”. Thirty-nine articles resulted from the search and 29 were included and evaluated by study authors. A total of 10 articles were excluded (9 not SCI focused or transplantation focused, 1 canine model). Key considerations for stem cell transplantation include method of delivery (intravenous, intrathecal, intramedullary, or excision and engraftment), time course of treatment, number of treatments and time from injury until treatment. There are no phase III clinical trials yet, but decreased time from injury to treatment and a greater number of stem cell injections both seem to increase the chance of functional recovery.
Core Tip: Beyond the biological diversity of stem cell transplantation for spinal cord injury are the technical considerations in designing clinical treatment paradigms. The data suggest that time from injury to treatment, the duration and chronicity of treatment and the actual delivery method of cells are important considerations. This evidence seems to suggest that longer treatment paradigms soon after injury may be most beneficial.