Evaluation of clinical experience using cell-based therapies in patients with spinal cord injury: a systematic review.

Authors

• James S Harrop
• Robin Hashimoto
• Dan Norvell
• Annie Raich
• Bizhan Aarabi
• Robert G Grossman
• James D Guest
• Charles H Tator
• Jens Chapman
• Michael G Fehlings

Publication/Presentation Date

9-1-2012

Abstract

OBJECT: Using a systematic approach, the authors evaluated the current utilization, safety, and effectiveness of cellular therapies for traumatic spinal cord injuries (SCIs) in humans.

METHODS: A systematic search and critical review of the literature published through mid-January 2012 was performed. Articles included in the search were restricted to the English language, studies with at least 10 patients, and those analyzing cellular therapies for traumatic SCI. Citations were evaluated for relevance using a priori criteria, and those that met the inclusion criteria were critically reviewed. Each article was then designated a level of evidence that was developed by the Oxford Centre for Evidence-Based Medicine.

RESULTS: The initial literature search identified 651 relevant articles, which decreased to 350 after excluding case reports and reviews. Evaluation of articles at the title/abstract level, and later at the full-text level, limited the final article set to 12 papers. The following cellular therapies employed in humans with SCI are reviewed: bone marrow mesenchymal and hematopoietic stem cells (8 studies), olfactory ensheathing cells (2 studies), Schwann cells (1 study), and fetal neurogenic tissue (1 study). Overall the quality of the literature was very low, with 3 Grade III levels of evidence and 9 Grade IV studies.

CONCLUSIONS: Several different cellular-mediated strategies for adult SCI have been reported to be relatively safe with varying degrees of neurological recovery. However, the literature is of low quality and there is a need for improved preclinical studies and prospective, controlled clinical trials.

Volume

17

Issue

1 Suppl

First Page

230

Last Page

246

ISSN

1547-5646

Published In/Presented At

Harrop, J. S., Hashimoto, R., Norvell, D., Raich, A., Aarabi, B., Grossman, R. G., Guest, J. D., Tator, C. H., Chapman, J., & Fehlings, M. G. (2012). Evaluation of clinical experience using cell-based therapies in patients with spinal cord injury: a systematic review. Journal of neurosurgery. Spine, 17(1 Suppl), 230–246. https://doi.org/10.3171/2012.5.AOSPINE12115

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

22985383

Department(s)

Administration and Leadership

Document Type

Article