Role of Surgery, Omentoplasty and Autologous Bone Marrow Derived Mononuclear Cells Infusion on Clinical Outcomes After Spinal Cord Injury- A Randomized Controlled Trial

Background: The hopelessness and helplessness experienced by spinal cord injury patients and treating doctors had triggered the innovations in the field of spinal cord injury management. Use of bone marrow mononuclear cells and stem/progenitor cells of desired lineage for the treatment of various diseases either alone or as add on to conventional treatment have shown promising results by several past and ongoing trials. Study purpose: To evaluate neurological recovery in patients of acute thoracolumbar, complete spinal injuries managed by five different treatment modalities. Patients and Methods: Total 110 patients (aged between 16-60 years) with unstable thoracolumbar spine injury (Thoracolumbar injury classification and severity score ≥ 4) between T9-L2 vertebra with complete paraplegia i.e. AISA (American Spinal Injury Association) grade ‘A’ with injury less than three week duration were randomly included for five different treatment modalities. Results: Among all the treatment modalities the group second i.e. conventional + bone marrow mononuclear cells infusion had shown the most significant result followed by group four i.e. conventional + bone marrow mononuclear cells along with omentoplasty. The group with least significance was group 3 i.e. conventional + omentoplasty. The conventional alone and conservative group showed result varying between above ones. Conclusions: The infusion of stem cells of bone marrow mononuclear cells along with conventional treatment among all the treatment modalities seems to augment neurological regeneration in SCI patients and indicate that BM derived stem cells may become valuable material for neurological problems as add on to conventional treatment in future.