Olfactory ensheathing cell transplantation in 106 patients with old spinal cord injury★ Differences in ages, sexes, disease courses, injured types and sites

BACKGROUND: It has been demonstrated that the transplantation of olfactory ensheathing cell (OEC) can promote the recovery of neurological function through ameliorating the local internal environment in spinal cord injury. OBJECTIVE: To evaluate the recent efficacy of OEC transplantation on old spinal cord injury. DESIGN: A self-controlled experiment. SETTING: Department of Neurosurgery, Taian Rongjun Hospital of Shandong Province. PARTICIPANTS: Totally 106 inpatients with old spinal cord injury were selected from the Department of Neurosurgery, Taian Rongjun Hospital of Shandong Province from June 2004 to December 2006, including 97 males and 9 females. Inclusive criteria: ① Complete data; ② Informed with the fact; ③ No further recover neurological function after drug therapy (neurotrophic factor, GM-1), traditional Chinese medicine, physiotherapy and rehabilitative exercises; ④ No obvious compression of the injured spinal cord displayed by MRI examination. METHODS: ① The olfactory bulb was obtained from embryo of induced labor in middle pregnancy above 4 months supplied voluntarily by pregnant women, and the survived cells after purification and culture for 1–2 weeks were collected. Dura mater was incised by posterior approach, then the cultured OEC suspension was transplanted to corresponding regions by means of multi-target injection using microscope. ② The patients were evaluated for twice with the standards suggested by American Spinal Injury Association (ASIA) at admission and 2–4 weeks postoperatively, in order to investigate the efficacy in different age groups, different sites and at different time points after the OEC transplantation. ③ Standards for evaluation: The International Standard for Neurological and Functional Classification of Spinal Cord Injury set by ASIA: The highest score of motor function was 100 points; The highest score of sensory function was 112 points for light touch and 112 for acupuncture sense. Frankel grading modified by ASIA in 1992: grades A, B, C, D and E (grade A for complete injury, and grade E for normal). ④ The data were statistically processed by Professor Cheng from the Department of Statistics, Taishan Medical College. MAIN OUTCOME MEASURES: Changes of motor and sensory functions postoperatively. RESULTS: All the 106 patients with old spinal cord injury were involved in the analysis of results. Grade A (n =72) at admission recovered to grade B in 31 cases and grade C in 7 cases after operation; Grade B (n =9) recovered to grade C in 2 cases; Grade C (n =15) recovered to grade D in 4 cases; Grade D (n =10) recovered to grade E in 1 cases, which referred to normal sensory and motor functions. The scores of motor, tactile sensation and pain sensation postoperatively were all obviously higher than those at admission (t =5.381, 7.036, 7.775, P < 0.05). The recovery of motor function had obvious difference among patients of different ages (F =5.235, P =0.001). There were no obvious differences in the recovery of motor and sensory functions among patients of different sexes, courses, injured types and sites. CONCLUSION: The neurological function can be ameliorated in a short time after OEC transplantation in patients with old spinal cord injury. The efficacy is generally the same in patients of different sexes, courses, injured types and sites, but there are differences in the effects on motor function of patients of different ages.

Olfactory ensheathing cell transplantation in 106 patients with old spinal cord injury Differences in ages, sexes, disease courses, injured types and sites

BackgroundIt has been demonstrated that the transplantation of olfactory ensheathing cell (OEC) can promote the recovery of neurological function through ameliorating the local internal environment in spinal cord injury.ObjectiveTo evaluate the recent efficacy of OEC transplantation on old spinal cord injury.DesignA self-controlled experiment.SettingDepartment of Neurosurgery, Taian Rongjun Hospital of Shandong Province.ParticipantsTotally 106 inpatients with old spinal cord injury were selected from the Department of Neurosurgery, Taian Rongjun Hospital of Shandong Province from June 2004 to December 2006, including 97 males and 9 females. Inclusive criteria:

Complete data;

Informed with the fact;

No further recover neurological function after drug therapy (neurotrophic factor, GM-1), traditional Chinese medicine, physiotherapy and rehabilitative exercises;

No obvious compression of the injured spinal cord displayed by MRI examination.Methods

The olfactory bulb was obtained from embryo of induced labor in middle pregnancy above 4 months supplied voluntarily by pregnant women, and the survived cells after purification and culture for 1–2 weeks were collected. Dura mater was incised by posterior approach, then the cultured OEC suspension was transplanted to corresponding regions by means of multi-target injection using microscope.

The patients were evaluated for twice with the standards suggested by American Spinal Injury Association (ASIA) at admission and 2–4 weeks postoperatively, in order to investigate the efficacy in different age groups, different sites and at different time points after the OEC transplantation.

Standards for evaluation: The International Standard for Neurological and Functional Classification of Spinal Cord Injury set by ASIA: The highest score of motor function was 100 points; The highest score of sensory function was 112 points for light touch and 112 for acupuncture sense. Frankel grading modified by ASIA in 1992: grades A, B, C, D and E (grade A for complete injury, and grade E for normal).

The data were statistically processed by Professor Cheng from the Department of Statistics, Taishan Medical College.Main Outcome MeasuresChanges of motor and sensory functions postoperatively.ResultsAll the 106 patients with old spinal cord injury were involved in the analysis of results. Grade A (n =72) at admission recovered to grade B in 31 cases and grade C in 7 cases after operation; Grade B (n =9) recovered to grade C in 2 cases; Grade C (n =15) recovered to grade D in 4 cases; Grade D (n =10) recovered to grade E in 1 cases, which referred to normal sensory and motor functions. The scores of motor, tactile sensation and pain sensation postoperatively were all obviously higher than those at admission (t =5.381, 7.036, 7.775, P < 0.05). The recovery of motor function had obvious difference among patients of different ages (F =5.235, P =0.001). There were no obvious differences in the recovery of motor and sensory functions among patients of different sexes, courses, injured types and sites.ConclusionThe neurological function can be ameliorated in a short time after OEC transplantation in patients with old spinal cord injury. The efficacy is generally the same in patients of different sexes, courses, injured types and sites, but there are differences in the effects on motor function of patients of different ages.