Spinal cord injuries (SCI) cause sensory loss and motor paralysis and are treated with physical therapy, but most patients fail to recover due to limited neural regeneration. Here we describe a strategy in which treatment with autologous adherent bone marrow cells is combined with physical therapy to improve motor and sensory functions in early-stage chronic SCI patients. In a phase I/II controlled single-blind clinical trial (clinicaltrials.gov identifier: NCT00816803), 70 chronic cervical and thoracic SCI patients with injury durations of at least 6 months were treated with either intrathecal injection(s) of autologous adherent bone marrow cells combined with physical therapy, or with physical therapy alone. Patients were evaluated with clinical examinations, electrophysiological somatosensory evoked potential, MRI imaging, and functional independence measurements. Chronic cervical and thoracic SCI patients treated with autologous adherent bone marrow cells combined with physical therapy showed functional improvements over patients in the control group treated with physical therapy alone, and there were no cell therapy-related side effects. At 18 months posttreatment, 23 of the 50 cell therapy-treated cases (46 percent) showed sustained improvement using the American Spinal Injury Association (ASIA) Impairment Scale (AIS). Compared to those patients with cervical injuries, a higher rate of functional improvement was achieved in thoracic SCI patients with shorter durations of injury and smaller cord lesions. Therefore, when combined with physical therapy, autologous adherent bone marrow cell therapy appears to be a safe and promising therapy for patients with chronic spinal cord injuries. Randomized controlled multicenter trials are warranted.

Disclosures W. Kamel: None.