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Journal of Neurorestoratology  2018, Vol. 6 Issue (1): 99-114    doi: 10.26599/JNR.2018.9040009
Research Article     
Translational experience of 28 years of use of the technologies of regenerative medicine to treat complex consequences of the brain and spinal cord trauma: Results, problems and conclusions
Andrey S. Bryukhovetskiy(✉)
NeuroVita Clinic of Restorative Interventional Neurology and Therapy, Moscow 115478, Russian Federation
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Abstract  

The retrospective study summarizes 28 years of cell therapy for neurotrauma of different origin. The four experimental groups were the groups of neurotrama that included traumatic disease of the spinal cord, traumatic disease of the brain and chronic vegetative post-traumatic state. The first group received transplantations of the fetal cells of neural tissue. The second group received the tissue engineering surgery with the transplantation of the fetal cells of neural tissue. The third group were the cases of the bioengineering pasty of the damaged brain tissue; and fourth were the cases of neurotrauma that were treated with the transplantation of the hematopoietic stem cells (HSCs) and hematopoietic precursor cells (HPCs). The long-term follow up proved the cell therapy with HSCs and HPCs to be the safest and most effective.



Key wordsneurotrauma      stem cells      cell transplantation      cell therapy      hematopoietic stem cells      spinal cord injury      traumatic brain injury      long-term results      tissue engineering     
Received: 10 July 2018      Published: 09 November 2018
Corresponding Authors: Andrey S. Bryukhovetskiy   
About author: §These authors contributed equally to this work.
Cite this article:

Andrey S. Bryukhovetskiy. Translational experience of 28 years of use of the technologies of regenerative medicine to treat complex consequences of the brain and spinal cord trauma: Results, problems and conclusions. Journal of Neurorestoratology, 2018, 6: 99-114.

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http://jnr.tsinghuajournals.com/10.26599/JNR.2018.9040009     OR     http://jnr.tsinghuajournals.com/Y2018/V6/I1/99

No.Type of neurotraumaClinical recordsCase numbersControl group
1Traumatic disease of the spinal cord13410227
2Traumatic disease of the brain13610624
3Chronic vegetative post- traumatic states19127
4Total28922058
Table?1The distribution of the neurotrauma cases of the 1st clinical group (allogeneic cells of fetal neural tissue).
No.Type of neurotraumaMalesFemalesControl group No. 1 ?(males only)
Number%Average ageNumber%Average ageNumber%Average age
1Traumatic disease of the spinal cord13044.919. 241.426.22746.518.8
2Traumatic disease of the brain13245.618.641.419.22441.419.5
3Chronic vegetative post-traumatic states165.520.420.719.8712.126.6
4Total27896.119.4103.421.75810021.63
Table?2Distribution of the 1 group (allogeneic cells of fetal neural tissue) cases by age and gender.
Fig.?1The stages of the interventional low invasive bioengineering plasty of the neural tissue of the human brain and spinal cord.
No.Type of neurotraumaNumber of recordsNumber of casesControl group No. 2
1Traumatic disease of the spinal cord171430988
2Traumatic disease of the brain2163134
3Chronic vegetative post-traumatic states43?5
4Total1973345127
Table?3Distribution of the Group #4 (autologous HSCs and HPCs) cases.
No.Type of neurotraumaMalesFemalesControl group No. 1?(males only)
Number%Average ageNumber%Average ageNumber%Average age
1Traumatic disease of the spinal cord25373.334.55616.242.48869.233.8
2Traumatic disease of the brain236.628.682.331.23426.739.5
3Chronic vegetative post-traumatic states41.1627.410.31953.9334.6
4Total28081.230.176518.830.8712710036.97
Table?4Distribution of Group 4 (HSCs and HPCs) cases by age and gender.
No.Type of neurotraumaConservative strategy ?(cell therapy)Surgical strategy ?(tissue engineering)Combined strategy ?(tissue engineering + ?cell therapy)
Number%Number%Number%
1Traumatic disease of the spinal cord22091.64795.91244. 4
2Traumatic disease of the brain145.824.11555.6
3Chronic vegetative post-traumatic states62.5
4Total 316 cases2401004910027100
Table?5Distribution of the neurotrauma cases depending of the strategies of regenerative medicine.
No.Type of neurotraumaDeteriorationNo effectEffectiveHighly effective
Number%Number%Number%Number%
1Traumatic disease of the spinal cord22091.64795.91244.45315.3
2Traumatic disease of the brain145.824.11555.630.86
3Chronic vegetative post-traumatic states62.510.3
4Total 346 cases61.79427.118954.65716,47
Table?6Effectiveness of the long-term therapy with HSCs and HPCs for different types of neurotrauma.
No.Type of neurotraumaDeteriorationNo effectEffectiveHighly effective
Number%Number%Number%Number%
1Traumatic disease of the spinal cord2746.6
2Traumatic disease of the brain2237.91
3Chronic vegetative post-traumatic states11.7712.1
4Total 58 cases11.75696.611.7--
Table?7Effectiveness of the conventional therapy of the control group 1 in different types of neurotrauma.
No.Type of neurotraumaDeteriorationNo effectEffectiveHighly effective
Number%Number%Number%Number%
1Traumatic disease of the spinal cord21.55845.62822.0
2Traumatic disease of the brain2217.31210.4
3Chronic vegetative post-traumatic states21.532.3
4Total 127 cases43.48365.44031.5
Table?8Effectiveness of the conventional therapy of the control Group 2 in different types of neurotrauma.
Fig.?2Four years follow-up of the SCI patients after administration of the autologous HSCs and HPCs (after 4 years).
No.Type of neurotraumaDeteriorationNo effectEffectiveHighly effective
Number%Number%Number%Number%
1Traumatic disease of the spinal cord62.016221.53644.43021,18
2Traumatic disease of the brain31.045117,76155.6217,29
3Chronic vegetative post-traumatic states10.34103,4731.1541,38
4Total 288 cases103.4712342,710034.75519.01
Table?9Effectiveness of the long-term therapy with allogeneic (fetal) preparations of neural tissue for different types of neurotrauma.
Fig.?3Restoration of suprasegmentary brain control over spinal reflexes after administration of the autologous HSCs and HPCs. (a) Absence of H-reflex habituation in patient R. with absent motor functions before treatment. (b) Increase of H-reflex habituation in patient R. with improved motor functions after autologous HSCs and HPCs therapy.
Fig.?4General efficiency of sensation restoration after administration of the autologous HSCs and HPCs (after 4 years).
Fig.?5Changes of ENMG somatosensory evoked potentials (SSEP) in patient Ch. with C5-C6 SCI during MAHSC therapy A- SSEP – normal variant В - SSEP patient Ch. before therapy С- SSEP patient Ch. after MAHSC administration in 6 months.
Fig.?6Implantation of the matrix and stem cells into the cyst: (a) the cyst of the spinal cord is opened and drained, and (b) external appearance of the spinal cord and implant.
Fig.?7The external appearance of the spinal cord of the patient S. During the tissue engineering surgery in 2007 at C5-C6 level. (a) Cicatricial and commissural degeneration of the spinal cord, calcification in the site of injury. (b) The state of the spinal cord after removal of the calcification, menigoradiculomyelolysis and implantation of the matrix and stem cells into the cyst. (c) State of the spinal cord during repeated surgery in 2009: completely restored blood supply, anatomical structure and electrical conductance in the site of injury.
Fig.?8The dynamics of SEP elicited by stimulation of left tibial nerve of C5 level SCI patient. The stem cell treatment was started 4 years after injury. Note the restoration of short-latency components – firstly N45 and then P38. The simultaneous latency reduction of the appeared components is seen. Note also the increase of late components amplitude.
Fig.?9Magnetic resonance imaging of the cervical spine three years post tissue engineering in patient C. MRI Conclusion: SCI, late period. Consequences of the compressive-comminuted fracture of C6 and C7 vertebrae, state post tissue engineering surgery. Corporectomy of C6 and C7. Complete dissection of the medullar substance of the spinal cord at the С6-С7 level with dural sac conductance disorder and MR-signs of subatrophic changes of the medullar substance of the intact segments. (a) T2 mode. (b) T1 mode. The tractography showed that the integrity of the medullar substance at C6-C7 level is disordered for 1.98 cm (while in 2013 the size of dissection was 1.14 cm×1.08 cm) but separate neural fiber bands (c, d) along lateral contours are seen. The CSF canal is obstructed.
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