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CC BY-NC-ND 4.0 · Asian J Neurosurg 2017; 12(04): 681-690
DOI: 10.4103/ajns.AJNS_351_16
Original Article

A method for reconstruction of severely damaged spinal cord using autologous hematopoietic stem cells and platelet-rich protein as a biological scaffold

Ahmed Ammar
Department of Neurosurgery, King Fahd University Hospital, Faculty of Medicine, University of Dammam, Al Khobar
,
Yasser Osman
1   Department of Heamatology, King Fahd University Hospital, Faculty of Medicine, University of Dammam, Al Khobar
,
Ahmed Hendam
Department of Neurosurgery, King Fahd University Hospital, Faculty of Medicine, University of Dammam, Al Khobar
,
Mohammed Hasen
Department of Neurosurgery, King Fahd University Hospital, Faculty of Medicine, University of Dammam, Al Khobar
,
Fatma Al Rubaish
2   Department of Internal Medicine, King Fahd University Hospital, Faculty of Medicine, University of Dammam, Al Khobar
,
Danya Al Nujaidi
2   Department of Internal Medicine, King Fahd University Hospital, Faculty of Medicine, University of Dammam, Al Khobar
,
Faisal Al Abbas
Department of Neurosurgery, King Fahd University Hospital, Faculty of Medicine, University of Dammam, Al Khobar
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Introduction: There have been attempts to alter the prognosis of severe spinal cord injury in different centers, but none of which have reliably altered the outcome. Some trials use stem cells (SCs) that produced widely differing results. We hereby add our experience in our center of a surgical reconstruction of the damaged spinal cord using a mixture of SCs and Platelet-Rich Protein (PRP) with fibrin coated as a biological scaffold. Materials and Methods: Four cases of severely damaged spinal cord have been operated for neurolysis and reconstruction of the spinal cord using SCs and platelet-rich protein (PRP) with fibrin coated harvested from the peripheral circulation of the patient. PRP serves to maintain the position of the SCs. One milliliter suspension contains an average of 2.8 × 106 of autologous hematopoietic SCs. Patients were intraoperatively monitored by somatosensory evoked potential, motor evoked potentials, and delta wave. They are clinically followed postoperatively and electromyogram was repeated every 2 weeks. Magnetic resonance imaging (MRI) was repeated regularly. The patients are followed up for a period between 2 and 3 years. Results: One patient demonstrated motor and objective sensory improvement (P = 0.05), two other patients reported subjective sensory improvement, and the fourth one remained without any improvement (P = 0.1). None of these patients demonstrated any sign of deterioration or complication either on the surgery or on implanting of the SCs. MRI clearly proved that the inserted biological scaffold remained in place of reconstruction. Conclusion: SCs may play a role in restoring spinal cord functions. However, the unsolved problems of the use of SCs and related ethical issues should be addressed.

Key-words:

Biological scaffold - hematopoietic autologous stem cells - plasma-rich protein - spinal cord injury


Publication History

Article published online:
20 September 2022

© 2017. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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