Neurological, functional, and quality of life outcomes following combined mesenchymal stem cell and Schwann cell therapy in spinal cord injury: a 9-year experience.

BACKGROUND

Spinal cord injury (SCI) often results in severe disabilities and significant socioeconomic burdens.

OBJECTIVE

This study aimed to evaluate the effects and safety of co-transplantation of autologous bone marrow-derived mesenchymal stem cells (MSCs) and Schwann cells (SCs) via the intrathecal route in patients with complete spinal cord injury (SCI). The analysis focused on the therapy's impact across various SCI subgroups (cervical vs. thoracolumbar, subacute vs. chronic) and the factors influencing its efficacy.

METHODS

This case series evaluated 106 patients with complete SCI treated with combined cell therapy between August 2013 and September 2022, with a one-year follow-up. Safety profiles were assessed, and neurological and functional outcomes were measured using the American Spinal Injury Association (ASIA) scores, Spinal Cord Independence Measure (SCIM-III), and the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) at 6- and 12-month intervals post-injection. Multiple regression analysis was conducted to evaluate factors associated with outcomes.

RESULTS

Significant improvements were observed in ASIA scores (motor, light touch, and pinprick), SCIM-III scores (total and subscales), and WHOQOL-BREF scores after 12 months. These improvements were consistent across subgroups, regardless of injury level or duration. Multiple regression analysis indicated that improvements in ASIA motor scores were associated with injury level, while improvements in SCIM-III total and mobility scores were associated with time since injury and patient age.

CONCLUSIONS

This study demonstrates significant neurological, functional, and quality of life improvements following combined cell therapy with autologous MSCs and SCs in patients with complete SCI. Future research should investigate potential synergies with other therapies and conduct comparative efficacy analyses.