AA

Neural Tissue Transplantation

Download as a PDF

A novel treatment for syringomyelia involves transplantation of neural tissue alone or in conjunction with surgical unthethering or cyst shunting. Embryonic spinal cord grafts have been shown to help repair structure and function of the spinal cord in experimental studies with an 80-90% survival rate (Houle & Reier 1988; Reier et al. 1988; Akesson et al. 1998). These grafts are used to fill the syrinx cavity and minimize cystic deformations in patients with progressive posttraumatic syringomyelia (Falci et al. 1997).

Two case reports (Falci et al. 1997; Wirth III et al. 2001), examined the use of embryonic tissue transplantation in the treatment of syringomyelia in patients post SCI. The studies involved untethering, cyst drainage and implantation of embryonic fetal tissue of SCI patients. Both studies reported collapse of cyst in the transplantation region and improvement in sensation. Improvement in spasticity was also observed, although it was short lived. Wirth III et al. (2001) demonstrated improvement in bladder functioning post-surgery, while Falci et al. (1997) showed significant improvement in deafferentation pain. At 7 month follow-up, MRI images showed no reoccurrence of the cyst in the transplantation region; however improvement of secondary complications were not maintained (Falci et al. 1997). Further investigation using studies with more subjects is required to make conclusions as to its clinical effectiveness.

Conclusions

There is level 5 evidence (from 2 case reports; Falci et al. 1997; Wirth III et al. 2001) that embryonic tissue transplantation along with drainage, untethering and shunting may obliterate syringomyelia cysts and improve sensory loss.

  • Embryonic tissue transplantation may destroy syringomyelia cysts and improve sensory loss.