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Updated: Jun 29, 2025
Author Spotlight: Long-Term Spinal Cord Slice Culture for Advancing Spinal Cord Regeneration Therapies
Published on: April 12, 2024
Current status and future perspectives on stem cell transplantation for spinal cord injury
Edoardo Agosti1, Marco Zeppieri2, Andrea Pagnoni1
1Division of Neu rosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia 25123, Italy.
Background:
Previous assessments of stem cell therapy for spinal cord injuries (SCI) have encountered challenges and constraints. Current research primarily emphasizes safety in early-phase clinical trials, while systematic reviews prioritize effectiveness, often overlooking safety and translational feasibility. This situation prompts inquiries regarding the readiness for clinical adoption.
Aim:
To offer an up-to-date systematic literature review of clinical trial results con cerning stem cell therapy for SCI.
Methods:
A systematic search was conducted across major medical databases [PubMed, Embase, Reference Citation Analysis (RCA), and Cochrane Library] up to October 14, 2023. The search strategy utilized relevant Medical Subject Heading (MeSH) terms and keywords related to "spinal cord", "injury", "clinical trials", "stem cells", "functional outcomes", and "adverse events". Studies included in this review consisted of randomized controlled trials and non-randomized controlled trials reporting on the use of stem cell therapies for the treatment of SCI.
Results:
In a comprehensive review of 66 studies on stem cell therapies for SCI, 496 papers were initially identified, with 237 chosen for full-text analysis. Among them, 236 were deemed eligible after excluding 170 for various reasons. These studies encompassed 1086 patients with varying SCI levels, with cervical injuries being the most common (42.2%). Bone marrow stem cells were the predominant stem cell type used (71.1%), with various administration methods. Follow-up durations averaged around 84.4 months. The 32.7% of patients showed functional impro vement from American spinal injury association Impairment Scale (AIS) A to B, 40.8% from AIS A to C, 5.3% from AIS A to D, and 2.1% from AIS B to C. Sensory improvements were observed in 30.9% of patients. A relatively small number of adverse events were recorded, including fever (15.1%), headaches (4.3%), muscle tension (3.1%), and dizziness (2.6%), highlighting the potential for SCI recovery with stem cell therapy.
Conclusion:
In the realm of SCI treatment, stem cell-based therapies show promise, but clinical trials reveal potential adverse events and limitations, underscoring the need for meticulous optimization of transplantation conditions and parameters, caution against swift clinical implementation, a deeper understanding of SCI pathophysiology, and addressing ethical, tumorigenicity, immunogenicity, and immunotoxicity concerns before gradual and careful adoption in clinical practice.
Insights
Stem cell therapy for spinal cord injury (SCI) shows promise, with some patients experiencing functional and sensory improvements. However, further research is needed to optimize treatments and address safety concerns before widespread clinical use.
Area of Science:
- Regenerative Medicine
- Neuroscience
- Clinical Trials
Background:
- Previous stem cell therapy assessments for spinal cord injuries (SCI) faced challenges.
- Current research often prioritizes safety in early trials, overlooking effectiveness and translational feasibility.
- This gap necessitates an evaluation of clinical readiness for stem cell treatments in SCI.
Purpose of the Study:
- To systematically review and analyze the results of clinical trials involving stem cell therapy for spinal cord injuries (SCI).
- To provide an updated overview of the current landscape of stem cell applications in SCI treatment.
Main Methods:
- A systematic literature search was performed across PubMed, Embase, RCA, and Cochrane Library up to October 2023.
- Keywords included "spinal cord", "injury", "clinical trials", "stem cells", "functional outcomes", and "adverse events".
- Included studies were randomized controlled trials and non-randomized controlled trials on stem cell therapy for SCI.
Main Results:
- The review analyzed 236 eligible studies involving 1086 patients with SCI, predominantly cervical injuries.
- Bone marrow stem cells were most common (71.1%), with observed functional improvements in AIS scores for 32.7% to 40.8% of patients and sensory improvements in 30.9%.
- Adverse events were infrequent, including fever (15.1%), headaches (4.3%), and dizziness (2.6%).
Conclusions:
- Stem cell-based therapies demonstrate potential for SCI treatment, evidenced by functional and sensory improvements.
- Limitations and potential adverse events necessitate careful optimization of transplantation parameters.
- Further research into SCI pathophysiology, ethical considerations, and safety (tumorigenicity, immunogenicity) is crucial before clinical adoption.
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