P S John, Ann Maria John, Jobin Mathew, Vidhu Joshy
{"title":"慢性脊髓损伤再生的生物学和药理学增强。","authors":"P S John, Ann Maria John, Jobin Mathew, Vidhu Joshy","doi":"10.1007/s43465-024-01328-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Prospective, randomized, single-blind, comparative study.</p><p><strong>Primary objective: </strong>To compare the efficacy of multiple bone marrow implantations and co-administration of citicoline to multiple bone marrow implantations alone in the treatment of chronic Spinal Cord Injury (SCI).</p><p><strong>Setting: </strong>The study was conducted at Fathima Matha Physiotherapy and Rehabilitation Center in Kottayam, India.</p><p><strong>Methods: </strong>Twenty-three participants with chronic traumatic SCI, classified as American Spinal Injury Association Impairment Scale (AIS) A, B, or C, were recruited and randomized into two groups. The first group (BMCT group) received multiple intrathecal implantations of autologous non-manipulated bone marrow aspirate along with oral citicoline (Cytidine Diphosphate Choline). The second group (BM group) received only multiple intrathecal bone marrow implantations. Patients were assessed at baseline and followed up every three months for 24 months.</p><p><strong>Results: </strong>Comprehensive evaluation upon completion of the treatment demonstrated statistically significant improvements in AIS, Spinal Cord Independence Measure (SCIM) score, Walking Index for Spinal Cord Injury (WISCI) score and modified Ashworth score in the BMCT group compared to the BM group. The BMCT group demonstrated statistically significant improvement in motor and sensory scores also. Fractional Anisotropy (FA) values of Diffusion Tensor Imaging (DTI) recorded statistically significant improvement in both the groups after treatment. The Diffusion Tensor Tractography (DTT) recorded considerable improvement only in the BMCT group.</p><p><strong>Conclusions: </strong>This study observed statistically significant functional and neurological recovery in the BMCT group. The statistically significant increase in FA values recorded in both groups and the post-treatment improvements in DTT and MRI in the BMCT group are imaging evidences of spinal cord regeneration.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-024-01328-8.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 3","pages":"438-449"},"PeriodicalIF":1.1000,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972996/pdf/","citationCount":"0","resultStr":"{\"title\":\"Biological and Pharmacological Enhancement of Regeneration in Chronic Spinal Cord Injury.\",\"authors\":\"P S John, Ann Maria John, Jobin Mathew, Vidhu Joshy\",\"doi\":\"10.1007/s43465-024-01328-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Prospective, randomized, single-blind, comparative study.</p><p><strong>Primary objective: </strong>To compare the efficacy of multiple bone marrow implantations and co-administration of citicoline to multiple bone marrow implantations alone in the treatment of chronic Spinal Cord Injury (SCI).</p><p><strong>Setting: </strong>The study was conducted at Fathima Matha Physiotherapy and Rehabilitation Center in Kottayam, India.</p><p><strong>Methods: </strong>Twenty-three participants with chronic traumatic SCI, classified as American Spinal Injury Association Impairment Scale (AIS) A, B, or C, were recruited and randomized into two groups. The first group (BMCT group) received multiple intrathecal implantations of autologous non-manipulated bone marrow aspirate along with oral citicoline (Cytidine Diphosphate Choline). The second group (BM group) received only multiple intrathecal bone marrow implantations. Patients were assessed at baseline and followed up every three months for 24 months.</p><p><strong>Results: </strong>Comprehensive evaluation upon completion of the treatment demonstrated statistically significant improvements in AIS, Spinal Cord Independence Measure (SCIM) score, Walking Index for Spinal Cord Injury (WISCI) score and modified Ashworth score in the BMCT group compared to the BM group. The BMCT group demonstrated statistically significant improvement in motor and sensory scores also. Fractional Anisotropy (FA) values of Diffusion Tensor Imaging (DTI) recorded statistically significant improvement in both the groups after treatment. The Diffusion Tensor Tractography (DTT) recorded considerable improvement only in the BMCT group.</p><p><strong>Conclusions: </strong>This study observed statistically significant functional and neurological recovery in the BMCT group. The statistically significant increase in FA values recorded in both groups and the post-treatment improvements in DTT and MRI in the BMCT group are imaging evidences of spinal cord regeneration.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-024-01328-8.</p>\",\"PeriodicalId\":13338,\"journal\":{\"name\":\"Indian Journal of Orthopaedics\",\"volume\":\"59 3\",\"pages\":\"438-449\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-01-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972996/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Orthopaedics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s43465-024-01328-8\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/3/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s43465-024-01328-8","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Biological and Pharmacological Enhancement of Regeneration in Chronic Spinal Cord Injury.
Study design: Prospective, randomized, single-blind, comparative study.
Primary objective: To compare the efficacy of multiple bone marrow implantations and co-administration of citicoline to multiple bone marrow implantations alone in the treatment of chronic Spinal Cord Injury (SCI).
Setting: The study was conducted at Fathima Matha Physiotherapy and Rehabilitation Center in Kottayam, India.
Methods: Twenty-three participants with chronic traumatic SCI, classified as American Spinal Injury Association Impairment Scale (AIS) A, B, or C, were recruited and randomized into two groups. The first group (BMCT group) received multiple intrathecal implantations of autologous non-manipulated bone marrow aspirate along with oral citicoline (Cytidine Diphosphate Choline). The second group (BM group) received only multiple intrathecal bone marrow implantations. Patients were assessed at baseline and followed up every three months for 24 months.
Results: Comprehensive evaluation upon completion of the treatment demonstrated statistically significant improvements in AIS, Spinal Cord Independence Measure (SCIM) score, Walking Index for Spinal Cord Injury (WISCI) score and modified Ashworth score in the BMCT group compared to the BM group. The BMCT group demonstrated statistically significant improvement in motor and sensory scores also. Fractional Anisotropy (FA) values of Diffusion Tensor Imaging (DTI) recorded statistically significant improvement in both the groups after treatment. The Diffusion Tensor Tractography (DTT) recorded considerable improvement only in the BMCT group.
Conclusions: This study observed statistically significant functional and neurological recovery in the BMCT group. The statistically significant increase in FA values recorded in both groups and the post-treatment improvements in DTT and MRI in the BMCT group are imaging evidences of spinal cord regeneration.
Supplementary information: The online version contains supplementary material available at 10.1007/s43465-024-01328-8.
期刊介绍：
IJO welcomes articles that contribute to Orthopaedic knowledge from India and overseas. We publish articles dealing with clinical orthopaedics and basic research in orthopaedic surgery. Articles are accepted only for exclusive publication in the Indian Journal of Orthopaedics. Previously published articles, articles which are in peer-reviewed electronic publications in other journals, are not accepted by the Journal. Published articles and illustrations become the property of the Journal. The copyright remains with the journal. Studies must be carried out in accordance with World Medical Association Declaration of Helsinki.
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