Pain Management

Mesenchymal Stromal Cells

Author YearCountry
PEDro Score
Research Design
Total Sample Size		 Methods Outcome
Vaquero et al. 2018Spain

Pre-Post

N=10

 Population: Mean age=45.1±10.6 yr; Gender: males=9, females=1; Time since injury=18.1±16.7 yr; Level of injury: C=5, T=2, L=3; Severity of injury: AIS A=3, B=2, C=3, D=2; Type pf pain=neuropathic.Intervention: Participants received intrathecal administrations of 100 million mesenchymal stromal cells (MSCs) into their subarachnoid space via lumbar puncture in mo 1, 4, and 7 of the study for a total of 300 million MSCs, with follow-up at 4, 7 and 10 mo.

Outcome Measures: Neuropathic pain scores (NP).

 1.     Over the follow-up period there is a clear significant reduction in NP scores for all but 1 patient.2.     Significant improvement from baseline to mo 4 for NP score, and this was maintained throughout the entire follow-up period (p=0.003).
Vaquero et al. 2018Spain

Pre-Post Extended Follow-Up

N=11

 Population: Mean age=44.9±10.2 yr; Gender: males=7, females=4; Time since injury=13.7±14.8 yr; Level of injury: C=4, T=4,L=3; Severity of injury: AIS A=3, B=4, C=3, D=1; Type pf pain=neuropathic.Intervention: Participants had 3 administrations of 100 million mesenchymal stromal cells (MSCs) into their subarachoid space via lumbar puncture over 3 mo, and were followed for 10 mo.

Outcome Measures: Efficacy analysis in 9 of the participants and safety analysis in 11, VAS

 1.     4 of 11 participants in the safety analysis group experienced mild adverse events (AE) to the extent of transitory sciatic pain, headaches and pain in area of lumbar puncture, with one serious AE unrelated to treatment.2.     8 participants had NP shown via VAS scores, but at follow-up all scores either decreased or became 0 (p=0.012), except for one participant whose NP was not modified.

Discussion

Two pre-post studies evaluated the effectiveness of intrathecal administrations of mesenchymal stromal cells into the subarachnoid space in improving neuropathic pain among those with SCI. The preliminary evidence from the studies suggest that the transplantation is safe, with mild adverse events. Reduction in neuropathic pain were seen in most patients at follow-up. Evidence regarding it’s use is still limited and warrants further examination.

Conclusion

There is level 4 evidence that mesenchymal stromal cells may improve pain post SCI.

Mesenchymal stromal cells may improve post-SCI pain.

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