TDNet Discover

Background: Spinal cord injuries (SCI) have a prevalence of 54 million people in the United States and cause significant distress for those affected. Current treatment options in clinical guidelines are not effective enough to notably decrease long-term morbidity. Purpose: This research sought to investigate the efficacy of stem cell therapy (SCT) in reducing morbidity in patients with SCI via measurement of the clinically relevant American Spinal Injury Association (ASIA) score. This was completed through a targeted evidence-based clinical review (ECBR) of one meta-analysis and two network meta-analyses. While a meta-analysis compares only two interventions, a network meta-analysis allows for comparison of more than two treatments using both direct and indirect evidence from randomized control trials in a single analysis. Methods: A systematic literature search was performed using PubMed, Google Scholar, MEDLINE, and Clinicaltrails.gov from December 2022 through January 2023. An EBCR was then performed dissecting two network meta-analyses and one meta-analysis. Results: 92 studies with a total of 4,030 patients were included in this EBCR. Patients who had previously sustained SCIs were treated with rehabilitative therapy (RT) alone or SCT with RT. The findings were indicative of statistically significant improvements in ASIA scores, Barthel Index, urinary function, and gastrointestinal function in patients throughout SCT groups. All three articles reported adverse effects (AEs) of SCT, notably headache, neurologic pain, and febrile reaction. These AEs were found to be minimal and resolved either spontaneously or were easily treated with medication. Conclusion: Stem cell therapy, in conjunction with rehabilitative therapy, improves ASIA motor score, ASIA sensory score, and ASIA Impairment Scale grades. Despite the thorough ⅲ investigation into the types of AEs patients experience, previous studies neglected to delve into the pathogenesis of these AEs, leaving the understanding of SCT incomplete. The adverse effects of SCT need to be further examined before implementation into clinical practice.