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Treatment of spinal cord injury (SCI) remains challenging. Considering the rapid developments in neurorestorative therapies for SCI, we have revised and updated the Clinical Therapeutic Guidelines for Neurorestoration in Spinal Cord Injury (2016 Chinese version) of the Chinese Association of Neurorestoratology (Preparatory) and China Committee of International Association of Neurorestoratology. Treatment of SCI is a systematic multimodal process that aims to improve survival and restore neurological function. These guidelines cover real-world comprehensive neurorestorative management of acute, subacute, and chronic SCI and include assessment and diagnosis, pre-hospital first aid, treatment, rehabilitation, and complication management.


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Clinical guidelines for neurorestorative therapies in spinal cord injury (2021 China version)

Show Author's information Xiaodong Guo1Yaping Feng2Tiansheng Sun3Shiqing Feng4Jiaguang Tang5Lin Chen6Xiaojian Cao7Haodong Lin8Xijing He9Meihua Li10Zhicheng Zhang3Guoyong Yin11Xifan Mei12Hongyun Huang13( )
Sino-Canada Spinal and Spinal Cord Injury Center, Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hebei, China
Department of Neurosurgery, The 920th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army, Kunming 650032, Yunnan, China
Department of Orthopedics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing 100700, China
Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin 300052, China
Department of Orthopedics, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
Department of Neurosurgery, Dongzhimen Hospital, Beijing University of Traditional Chinese Medicine, Beijing 100007, China
Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China
Department of Orthopedic Surgery, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China
Department of Orthopedics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi, China
Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
Department of Orthopedics, Jiangsu Province Hospital, Nanjing 210029, Jiangsu, China
Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, Liaoning, China
Beijing Hongtianji Neuroscience Academy, Beijing 100143, China

Abstract

Treatment of spinal cord injury (SCI) remains challenging. Considering the rapid developments in neurorestorative therapies for SCI, we have revised and updated the Clinical Therapeutic Guidelines for Neurorestoration in Spinal Cord Injury (2016 Chinese version) of the Chinese Association of Neurorestoratology (Preparatory) and China Committee of International Association of Neurorestoratology. Treatment of SCI is a systematic multimodal process that aims to improve survival and restore neurological function. These guidelines cover real-world comprehensive neurorestorative management of acute, subacute, and chronic SCI and include assessment and diagnosis, pre-hospital first aid, treatment, rehabilitation, and complication management.

Keywords: cell therapy, neurorestoration, spinal cord injury, neurorehabilitation, neurotization, clinical therapeutic guideline

References(190)

[1]
Sekhon LH, Fehlings MG. Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine (Phila Pa 1976) 2001, 26(24 Suppl): S2-S12.
[2]
GBD Traumatic Brain Injury and Spinal Cord Injury Collaborators. Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019, 18(1): 56-87.
[3]
Sun TS. Present status and prospect of spinal cord injury in China (in Chinese). Chin J Spine Spinal Cord 2014, 24(12): 1057-1059.
[4]
Specialised Committee of Spine and Spinal Cord Injury, Chinese Society of Rehabilitation Medicine. Expert consensus on evaluation and treatment of early thoracolumbar spine and spinal cord injury (in Chinese). Chin J Spine Spinal Cord 2011, 21(11): 963-968.
[5]
Feng YP, Zhang X, Feng Y, et al. Early comprehensive treatment strategy for acute spinal cord injury (in Chinese). Chin J Neurosurg Dis Res 2014, 13(5): 385-388.
[6]
Reinhardt JD, Zheng Y, Xu G, et al. People with spinal cord injury in China. Am J Phys Med Rehabil 2017, 96(2 Suppl1): S61-S65.
[7]
Yuan SY, Shi ZJ, Cao FJ, et al. Epidemiological features of spinal cord injury in China: a systematic review. Front Neurol 2018, 9: 683.
[8]
Kang Y, Ding H, Zhou HX, et al. Epidemiology of worldwide spinal cord injury: a literature review. J Neurorestoratology 2018, 6: 1-9.
[9]
Huang HY, Sun TS, Chen L, et al. Consensus of clinical neurorestorative progress in patients with complete chronic spinal cord injury. Cell Transplant 2014, 23(Suppl 1): S5-S17.
[10]
Young W. Electrical stimulation and motor recovery. Cell Transplant 2015, 24(3): 429-446.
[11]
Hurlbert RJ, Hadley MN, Walters BC, et al. Pharmacological therapy for acute spinal cord injury. Neurosurgery 2015, 76(Suppl 1): S71-S83.
[12]
Huang HY, Sharma HS, Chen L, et al. 2018 Yearbook of Neurorestoratology. J Neurorestoratology 2019, 1(1): 11-20.
[13]
Huang HY, Chen L, Mao G, et al. The 2019 Yearbook of Neurorestoratology. J Neurorestoratology 2020, 8(1): 1-11.
[14]
Feng YP, Sun TS, Chen L, et al. Clinical therapeutic guideline for neurorestoration in spinal cord injury (Chinese version 2016). J Neurorestoratology 2017, 5: 73-83.
[15]
Huang HY, Raisman G, Sanberg PR, et al. Neurorestoratology. New York: Nova Biomedical, 2015.
[16]
Stein DM, Sheth KN. Management of acute spinal cord injury. Continuum 2015, 21:159-187.
[17]
Ropper AE, Neal MT, Theodore N. Acute management of traumatic cervical spinal cord injury. Pract Neurol 2015, 15(4): 266-272.
[18]
Kirshblum SC, Burns SP, Biering-Sorensen F, et al. International standards for neurological classification of spinal cord injury (revised 2011). J Spinal Cord Med 2011, 34(6): 535-546.
[19]
Kirshblum S, Snider B, Eren F, et al. Characterizing natural recovery after traumatic spinal cord injury. J Neurotrauma 2021, in press, .
[20]
Kirshblum S, Snider B, Rupp R, et al. Updates of the International Standards for Neurologic Classification of Spinal Cord Injury: 2015 and 2019. Phys Med Rehabil Clin N Am 2020, 31(3): 319-330.
[21]
Ryken TC, Hadley MN, Walters BC, et al. Radiographic assessment. Neurosurgery. 2013, 72(Suppl 2): 54-72.
[22]
Acheson MB, Livingston RR, Richardson ML, et al. High-resolution CT scanning in the evaluation of cervical spine fractures: comparison with plain film examinations. Am J Roentgenol 1987, 148(6): 1179-1185.
[23]
Zhu FZ, Liu Y, Zeng L, et al. Evaluating the severity and prognosis of acute traumatic cervical spinal cord injury: A novel classification using diffusion tensor imaging and diffusion tensor tractography. Spine 2020, in press, .
[24]
Lammertse D, Dungan D, Dreisbach J, et al. Neuroimaging in traumatic spinal cord injury: an evidence-based review for clinical practice and research. J Spinal Cord Med 2007, 30(3): 205-214.
[25]
Alshorman JAS, Wang YL, Zhu FZ, et al. Clinical diagnosis and treatment of spinal cord injury without evidence of abnormality in children: a review. Int Surg J 2020, 7(11): 3847.
[26]
Song KJ, Kim GH, Lee KB. The efficacy of the modified classification system of soft tissue injury in extension injury of the lower cervical spine. Spine (Phila Pa 1976) 2008, 33(15): E488-E493.
[27]
Fehlings MG, Martin AR, Tetreault LA, et al. A clinical practice guideline for the management of patients with acute spinal cord injury: Recommendations on the role of baseline magnetic resonance imaging in clinical decision making and outcome prediction. Global Spine J 2017, 7(3 Suppl): 221S-230S.
[28]
Freund P, Seif M, Weiskopf N, et al. MRI in traumatic spinal cord injury: from clinical assessment to neuroimaging biomarkers. Lancet Neurol 2019, 18(12): 1123-1135.
[29]
Martin AR, Aleksanderek I, Cohen-Adad J, et al. Translating state-of-the-art spinal cord MRI techniques to clinical use: A systematic review of clinical studies utilizing DTI, MT, MWF, MRS, and fMRI. Neuroimage Clin 2016, 10: 192-238.
[30]
Zhu FZ, Zeng L, Gui S, et al. The role of diffusion tensor imaging and diffusion tensor tractography in the assessment of acute traumatic thoracolumbar spinal cord injury. World Neurosurg 2021: S1878-S8750(21)00177-7.
[31]
Anand T, Hanna K, Kulvatunyou N, et al. Time to tracheostomy impacts overall outcomes in patients with cervical spinal cord injury. J Trauma Acute Care Surg 2020, 89(2): 358-364.
[32]
Yılmaz T, Kaptanoğlu E. Current and future medical therapeutic strategies for the functional repair of spinal cord injury. World J Orthop 2015, 6(1): 42-55.
[33]
Ropper AE, Ropper AH. Acute spinal cord compression. N Engl J Med 2017, 376(14): 1358-1369.
[34]
Alizo, Georgina, Sciarretta, et al. Multidisciplinary team approach to traumatic spinal cord injuries: a single institution's quality improvement project. Eur J Trauma Emerg Surg 2018, 44(2): 245-250.
[35]
Rhodes LN, Weatherford B, Locke LN, et al. A multidisciplinary approach to providing care to adolescents with spinal cord trauma resulting from all-terrain vehicle accidents. J Trauma Nurs 2015, 22(1): 23-27.
[36]
Bach JA, Leskovan JJ, Scharschmidt T, et al. The right team at the right time - Multidisciplinary approach to multi-trauma patient with orthopedic injuries. Int J Crit Illn Inj Sci 2017, 7(1): 32-37.
[37]
Wang YL, Zhu FZ, Zeng L, et al. Guideline for diagnosis and treatment of spine trauma in the epidemic of COVID-19. Chin J Traumatol 2020, 23(4): 196-201.
[38]
Wang YL, Zeng L, Yao S, et al. Recommendations of protective measures for orthopedic surgeons during COVID-19 pandemic. Knee Surg Sports Traumatol Arthrosc 2020, 28(7): 2027-2035.
[39]
Schilero GJ, Bauman WA, Radulovic M. Traumatic spinal cord injury: pulmonary physiologic principles and management. Clin Chest Med 2018, 39(2): 411-425.
[40]
China Trauma Rescue and Treatment Association. Consensus on the establishment of urban trauma rescue system in China (in Chinese). Chin J Surg 2017, 55(11): 830-833.
[41]
Bracken MB, Shepard MJ, Collins WF, et al. A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the Second National Acute Spinal Cord Injury Study. N Engl J Med 1990, 322(20): 1405-1411.
[42]
Liu Z, Yang Y, He L, et al. High-dose methylprednisolone for acute traumatic spinal cord injury: a meta-analysis. Neurology 2019, 93(9): e841-e850.
[43]
Bracken MB. Steroids for acute spinal cord injury. Cochrane Database Syst Rev 2002(3): CD001046.
[44]
Evaniew N, Noonan VK, Fallah N, et al. Methylprednisolone for the treatment of patients with acute spinal cord injuries: a propensity score-matched cohort study from a Canadian multi-center spinal cord injury registry. J Neurotrauma 2015, 32(21):1674-83.
[45]
Hurlbert RJ, Hadley MN, Walters BC, et al. Pharmacological therapy for acute spinal cord injury. Neurosurgery 2013, 72(Suppl 2): 93-105.
[46]
Fehlings MG, Wilson JR, Tetreault LA, et al. A clinical practice guideline for the management of patients with acute spinal cord injury: recommendations on the use of methylprednisolone sodium succinate. Global Spine J 2017, 7(3 Suppl): 203S-211S.
[47]
Xu DY, Yang LB, Li YP, et al. Clinical study of ganglioside (GM) combined with methylprednisolone (MP) for early acute spinal injury. Pak J Pharm Sci 2015, 28(2 Suppl): 701-704.
[48]
Latov N, Koski CL, Walicke PA. Guillain-Barré syndrome and parenteral gangliosides. Lancet 1991, 338(9): 757.
[49]
Landi G, D'Alessandro R, Dossi BC, et al. Guillain- Barre syndrome after exogenous gangliosides in Italy. BMJ 1993, 307(6917): 1463-1464.
[50]
Cozzens JW, Prall JA, Holly L. The 2012 guidelines for the management of acute cervical spine and spinal cord injury. Neurosurgery 2013, 72(Suppl 2): 2-3.
[51]
Ahuja CS, Wilson JR, Nori S, et al. Traumatic spinal cord injury. Nat Rev Dis Primers 2017, 3: 17018.
[52]
Tran AP, Warren PM, Silver J. The biology of regeneration failure and success after spinal cord injury. Physiol Rev 2018, 98(2): 881-917.
[53]
Venkatesh K, Ghosh SK, Mullick M, et al. Spinal cord injury: pathophysiology, treatment strategies, associated challenges, and future implications. Cell Tissue Res 2019, 377(2): 125-151.
[54]
Altaf F, Griesdale DE, Belanger L, et al. The differential effects of norepinephrine and dopamine on cerebrospinal fluid pressure and spinal cord perfusion pressure after acute human spinal cord injury. Spinal Cord 2017, 55(1): 33-38
[55]
Inoue T, Manley GT, Patel N, et al. Medical and surgical management after spinal cord injury: vasopressor usage, early surgerys, and complications. J Neurotrauma 2014, 31(3): 284-291.
[56]
Readdy WJ, Whetstone WD, Ferguson AR, et al. Complications and outcomes of vasopressor usage in acute traumatic central cord syndrome. J Neurosurg Spine 2015, 23(5): 574-580.
[57]
Evaniew N, Mazlouman SJ, Belley-Côté EP, et al. Interventions to optimize spinal cord perfusion in patients with acute traumatic spinal cord injuries: a systematic review. J Neurotrauma 2020, 37(9): 1127-1139.
[58]
Alkabie S, Boileau AJ. The role of therapeutic hypothermia after traumatic spinal cord injury——A systematic review. World Neurosurg 2016, 86: 432-449.
[59]
Kafka J, Lukacova N, Sulla I, et al. Hypothermia in the course of acute traumatic spinal cord injury. Acta Neurobiol Exp (Wars) 2020, 80(2): 172-178.
[60]
Cappuccino A, Bisson LJ, Carpenter B, et al. Systemic hypothermia as treatment for an acute cervical spinal cord injury in a professional football player: 9-year follow-up. Am J Orthop (Belle Mead NJ) 2017, 46(2): E79-E82.
[61]
Tator CH, Deecke L. Value of normothermic perfusion, hypothermic perfusion, and durotomy in the treatment of experimental acute spinal cord trauma. J Neurosurg 1973, 39(1): 52-64.
[62]
Arnaez J, Miranda M, Rinones E, et al. Whole-body cooling and erythropoietin in neonatal cervical spine injury. Ther Hypothermia Temp Manag 2019, 9(2): 159-162.
[63]
Pelletier JH, Mann CH, German BT, et al. Therapeutic systemic hypothermia for a pediatric patient with an isolated cervical spinal cord injury. J Spinal Cord Med 2020, 43(2): 264-267.
[64]
Hansebout RR, Hansebout CR. Local cooling for traumatic spinal cord injury: outcomes in 20 patients and review of the literature. J Neurosurg Spine 2014, 20(5): 550-561.
[65]
Gallagher MJ, Hogg FRA, Kearney S, et al. Effects of local hypothermia-rewarming on physiology, metabolism and inflammation of acutely injured human spinal cord. Sci Rep 2020, 10(1): 8125.
[66]
Tzen YT, Brienza DM, Karg PE, et al. Effectiveness of local cooling for enhancing tissue ischemia tolerance in people with spinal cord injury. J Spinal Cord Med 2013, 36(4): 357-364.
[67]
Chinese Association of Orthopedic Surgeons. Evidence-based guideline for the management of acute subaxial cervical spine injury (in Chinese). Chin J Surg 2018, 56(1): 5-9.
[68]
Zhu FZ, Yao S, Ren ZW, et al. Early durotomy with duroplasty for severe adult spinal cord injury without radiographic abnormality: a novel concept and method of surgical decompression. Eur Spine J 2019, 28(10): 2275-2282.
[69]
Qu YZ, Luo Z, Guo XD, et a1. The durotomy or myelotomy for the spinal cord extensive swelling with/without intrameduary hemorrhage (in Chinese). Chin J Orthop 2015, 35(7): 707-713.
[70]
Qu YZ, Guo XD. Durotomy and dural grafting to treat lower cervical spine injuries with extensive spinal cord edema. Neural Regen Res 2015, 10(12): 1969-1970.
[71]
Telemacque D, Zhu FZ, Chen KF, et al. Method of decompression by durotomy and duroplasty for cervical spinal cord injury in patients without fracture or dislocation. J Neurorestoratology 2018, 6(1): 158-164.
[72]
Telemacque D, Zhu FZ, Ren ZW, et al. Effects of durotomy versus myelotomy in the repair of spinal cord injury. Neural Regen Res 2020, 15(10): 1814-1820.
[73]
Wang YL, Zhu FZ, Zeng L, et al. Surfer myelopathy in children: a case series study. World Neurosurg 2021, 148: e227-e241.
[74]
Piazza M, Schuster J. Timing of surgery after spinal cord injury. Neurosurg Clin N Am 2017, 28(1): 31-39.
[75]
Liu JM, Long XH, Zhou Y, et al. Is urgent decompression superior to delayed surgery for traumatic spinal cord injury? A meta-analysis. World Neurosurg 2016, 87: 124-131.
[76]
Badhiwala JH, Ahuja CS, Fehlings MG. Time is spine: a review of translational advances in spinal cord injury. J Neurosurg Spine 2018, 30(1): 1-18.
[77]
Fehlings MG, Tetreault LA, Aarabi B, et al. A clinical practice guideline for the management of patients with acute spinal cord injury: Recommendations on the type and timing of rehabilitation. Global Spine J 2017, 7(3 suppl): 231S-238S.
[78]
Grassner L, Wutte C, Klein B, et al. Early decompression (< 8 h) after traumatic cervical spinal cord injury improves functional outcome as assessed by spinal cord independence measure after one year. J Neurotrauma 2016, 33(18): 1658-1666.
DOI
[79]
Sewell MD, Vachhani K, Alrawi A, et al. Results of early and late surgical decompression and stabilization for acute traumatic cervical spinal cord injury in patients with concomitant chest injuries. World Neurosurg 2018, 118: e161-e165.
[80]
Furlan JC, Craven BC, Massicotte EM, et al. Early versus delayed surgical decompression of spinal cord after traumatic cervical spinal cord injury: a cost- utility analysis. World Neurosurg 2016, 88: 166-174.
[81]
Dvorak MF, Noonan VK, Fallah N, et al. The influence of time from injury to surgery on motor recovery and length of hospital stay in acute traumatic spinal cord injury: an observational Canadian cohort study. J Neurotrauma 2015, 32(9): 645-654.
[82]
El Tecle NE, Dahdaleh NS, Hitchon PW. Timing of surgery in spinal cord injury. Spine 2016, 41(16): E995-E1004.
[83]
Wilson JR, Tetreault LA, Kwon BK, et al. Timing of decompression in patients with acute spinal cord injury: a systematic review. Global Spine J 2017, 7(3 Suppl): 95S-115S.
[84]
Wutte C, Klein B, Becker J, et al. Earlier decompression (< 8 hours) results in better neurological and functional outcome after traumatic thoracolumbar spinal cord injury. J Neurotrauma 2019, 36(12): 2020-2027.
DOI
[85]
Fehlings MG, Vaccaro A, Wilson JR, et al. Early versus delayed decompression for traumatic cervical spinal cord injury: results of the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS). PLoS One 2012, 7(2): e32037.
[86]
Wilson JR, Witiw CD, Badhiwala J, et al. Early surgery for traumatic spinal cord injury: where are we now? Global Spine J 2020, 10(1 Suppl): 84S-91S.
[87]
TerWengel PV, De Witt Hamer PC, Pauptit JC, et al. early surgical decompression improves neurological outcome after complete traumatic cervical spinal cord injury: a meta-analysis. J Neurotrauma 2019, 36(6): 835-844.
[88]
Vaccaro AR, Hulbert RJ, Patel AA, et al. The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex. Spine (Phila Pa 1976) 2007, 32(21): 2365-2374.
[89]
Vaccaro AR, Lehman RA Jr, Hurlbert RJ, et al. A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status. Spine (Phila Pa 1976) 2005, 30(20): 2325-2333.
[90]
Nassr A, Lee JY, Dvorak MF, et a1. Variations in surgical treatment of cervical facet dislocations. Spine (Phila Pa 1976) 2008, 33(7): E188-E193.
[91]
Nakashima H, Yukawa Y, Ito K, et al. Posterior approach for cervical fracture-dislocations with traumatic disc herniation. Eur Spine J 2011, 20(3): 387-394.
[92]
Aarabi B, Olexa J, Chryssikos T, et al. Extent of spinal cord decompression in motor complete (American Spinal Injury Association Impairment Scale Grades A and B) traumatic spinal cord injury patients: post-operative magnetic resonance imaging analysis of standard operative approaches. J Neurotrauma 2019, 36(6): 862-876.
[93]
Dai LY, Li H. Diagnosis and operation of lower cervical spine injury. Chin J Surg 2007, 45(6): 396-401.
[94]
Grassner L, Andreas Grillhösl, Griessenauer C J, et al. Spinal meninges and their role in spinal cord injury: a neuroanatomical review. J Neurotrauma 2018, 35(3): 403-410.
[95]
Sakka L, Gabrillargues J, Coll G. Anatomy of the spinal meninges. Oper Neurosurgery (Hagerstown), 2015, 12(2): 168-188.
[96]
Allen AR. Surgery of experimental lesion of spinal cord equivalent to crush injury of fracture dislocation of spinal column. J Am Med Assoc 1911, LVII(11): 878.
[97]
Rivlin AS, Tator CH. Effect of vasodilators and myelotomy on recovery after acute spinal cord injury in rats. J Neurosurg 1979, 50(3): 349-352.
[98]
Kandziora F, Pingel A. Expert's comment concerning Grand Rounds case entitled: "Increased intrathecal pressure after traumatic spinal cord injury: an illustrative case presentation and a review of the literature" by Grassner L, Winkler PA, Strowitzki M, et al. (Eur Spine J (2016). doi:10.1007/s 00586- 016-4769-9): Surgical treatment of SICS (spinal intradural compartment syndrome). Eur Spine J 2017, 26(1): 26-27.
[99]
Tachibana S, Okada K, Ohwada T, et al. Posterior longitudinal myelotomy as a surgical treatment of acute cervical spinal cord injury (in Japanese). No Shinkei Geka 1984, 12(2): 183-188.
[100]
Badhiwala JH, Wilson JR, Witiw CD, et al. The influence of timing of surgical decompression for acute spinal cord injury: a pooled analysis of individual patient data. Lancet Neurol 2021, 20(2): 117-126.
[101]
Huang HY, Young W, Skaper S, et al. Clinical neurorestorative therapeutic guidelines for spinal cord injury (IANR/CANR version 2019). J Orthop Translat 2019, 20: 14-24.
[102]
Huang H, Young W, Chen L, et al. Clinical cell therapy guidelines for neurorestoration (IANR/ CANR 2017). Cell Transplant 2018, 27(2): 310-324.
[103]
Guo X, Zahir T, Mothe A, et al. The effect of growth factors and soluble Nogo-66 receptor protein on transplanted neural stem/progenitor survival and axonal regeneration after complete transection of rat spinal cord. Cell Transplant 2012, 21(6): 1177-1197.
[104]
Lammertse DP, Jones LA, Charlifue SB, et al. Autologous incubated macrophage therapy in acute, complete spinal cord injury: results of the phase 2 randomized controlled multicenter trial. Spinal Cord 2012, 50(9): 661-671.
[105]
Galipeau J, Krampera M, Barrett J, et al. International Society for Cellular Therapy perspective on immune functional assays for mesenchymal stromal cells as potency release criterion for advanced phase clinical trials. Cytotherapy 2016, 18(2): 151-159.
[106]
McDonald JW, Becker D. Spinal cord injury: promising interventions and realistic goals. Am J Phys Med Rehabil 2003, 82(10 Suppl): S38-S49.
[107]
Calvert JS, Grahn PJ, Zhao KD, et al. Emergence of epidural electrical stimulation to facilitate sensorimotor network functionality after spinal cord injury. Neuromodulation 2019, 22(3): 244-252.
[108]
Fadeev F, Eremeev A, Bashirov F, et al. Combined supra- and sub-lesional epidural electrical stimulation for restoration of the motor functions after spinal cord injury in mini pigs. Brain Sci 2020, 10(10): 744.
[109]
Luo SY, Xu HN, Zuo Y, et al. A review of functional electrical stimulation treatment in spinal cord injury. Neuromolecular Med 2020, 22(4): 447-463.
[110]
Dimitrijevic M, Krenn M, Mayr W, et al. Human Spinal Cord Motor Control That Is Partially or Completely Disconnected from the Brain. Vol. 8. American Scientific Publishers, 2016, pp 12-26.
DOI
[111]
Gassaway J, Jones ML, Sweatman WM, et al. Effects of peer mentoring on self-efficacy and hospital readmission after inpatient rehabilitation of individuals with spinal cord injury: a randomized controlled trial. Arch Phys Med Rehabilitation 2017, 98(8): 1526-1534.e2.
[112]
Huang HY, Xi HT, Chen L, et al. Long-term outcome of olfactory ensheathing cell therapy for patients with complete chronic spinal cord injury. Cell Transplant 2012, 21(Suppl 1): S23-S31.
[113]
Urbin MA, Ozdemir RA, Tazoe T, et al. Spike-timing-dependent plasticity in lower-limb motoneurons after human spinal cord injury. J Neurophysiol 2017, 118(4): 2171-2180.
[114]
Itzkovich M, Gelernter I, Biering-Sorensen F, et al. The Spinal Cord Independence Measure (SCIM) version III: reliability and validity in a multi-center international study. Disabil Rehabil 2007, 29(24): 1926-1933.
[115]
Mingaila S, Krisciūnas A. Occupational therapy for patients with spinal cord injury in early rehabilitation. Medicina (Kaunas) 2005, 41(10): 852-856.
[116]
Grigorean VT, Sandu AM, Popescu M, et al. Cardiac dysfunctions following spinal cord injury. J Med Life 2009, 2(2): 133-145.
[117]
Mazensky D, Flesarova S, Sulla I. Arterial blood supply to the spinal cord in animal models of spinal cord injury. A review. Anat Rec (Hoboken) 2017, 300(12): 2091-2106.
[118]
Haldrup M, Dyrskog S, Thygesen MM, et al. Initial blood pressure is important for long-term outcome after traumatic spinal cord injury. J Neurosurg Spine 2020: 1-5.
[119]
Tee JW, Altaf F, Belanger L, et al. Mean arterial blood pressure management of acute traumatic spinal cord injured patients during the pre-hospital and early admission period. J Neurotrauma 2017, 34(6): 1271-1277.
[120]
Gallagher MJ, Hogg FRA, Zoumprouli A, et al. Spinal cord blood flow in patients with acute spinal cord injuries. J Neurotrauma 2019, 36(6): 919-929.
[121]
Hawryluk G, Whetstone W, Saigal R, et al. Mean arterial blood pressure correlates with neurological recovery after human spinal cord injury: analysis of high frequency physiologic data. J Neurotrauma 2015, 32(24): 1958-1967.
[122]
Readdy WJ, Dhall SS. Vasopressor administration in spinal cord injury: should we apply a universal standard to all injury patterns? Neural Regen Res 2016, 11(3): 420-421.
[123]
Ohbe H, Koakutsu T, Kushimoto S. Analysis of risk factors for hyponatremia in patients with acute spinal cord injury: a retrospective single-institution study in Japan. Spinal Cord 2019, 57(3): 240-246.
[124]
Song PW, Dong FL, Feng CC, et al. A study of predictors for hyponatraemia in patients with cervical spinal cord injury. Spinal Cord 2018, 56(1): 84-89.
[125]
Sabharwal S, Fox AD, Vives MJ. The use of inferior vena cava filters in spine trauma: a nationwide study using the National Trauma Data Bank. J Spinal Cord Med 2019, 42(2): 228-235.
[126]
Tollefsen E, Fondenes O. Respiratory complications associated with spinal cord injury. Tidsskr Nor Laegeforen 2012, 132(9): 1111-1114.
[127]
Wu Q, Li YL, Ning GZ, et al. Epidemiology of traumatic cervical spinal cord injury in Tianjin, China. Spinal Cord 2012, 50(10):740-744.
[128]
Arber S. Motor circuits in action: specification, connectivity, and function. Neuron 2012, 74(6): 975-989.
[129]
Carlsson CA, Sundin T. Reconstruction of efferent pathways to the urinary bladder in a paraplegic child. Rev Surg 1967, 24(1): 73-76.
[130]
Carlsson CA, Sundin T. Reconstruction of afferent and efferent nervous pathways to the urinary bladder in two paraplegic patients. Spine (Phila Pa 1976) 1980, 5(1): 37-41.
[131]
Zhang SC, Johnston L, Zhang ZW, et al. Restoration of stepping-forward and ambulatory function in patients with paraplegia: rerouting of vascularized intercostal nerves to lumbar nerve roots using selected interfascicular anastomosis. Surg Technol Int 2003, 11:244-248.
[132]
Yang ML, Li JJ, Zhang SC, et al. Functional restoration of the paralyzed diaphragm in high cervical quadriplegia via phrenic nerve neurotization utilizing the functional spinal accessory nerve. J Neurosurg Spine 2011, 15(2): 190-194.
[133]
Xiao CG, Godec CJ. A possible new reflex pathway for micturition after spinal cord injury. Paraplegia 1994, 32(5): 300-307.
[134]
Xiao CG, Du MX, Dai CP, et al. An artificial somatic-central nervous system-autonomic reflex pathway for controllable micturition after spinal cord injury: preliminary results in 15 patients. J Urol 2003, 170(4 Pt 1): 1237-1241.
[135]
Zhou X, Liu Y, Ma J, et al. Extradural nerve anastomosis technique for bladder reinnervation in spinal cord injury anatomical feasibility study in human cadavers. Spine (Phila Pa 1976) 2014, 39(8): 635-641.
[136]
Yang KX, Chen HT, Tang J, et al. Anatomical feasibility of extradural transferring S2 and S3 ventral roots to S1 ventral root for restoring neurogenic bladder in spinal cord injury. Spine 2018, 43(18): E1046-E1052.
[137]
Lin HD, Hou CL, Zhong GB, et al. Reconstruction of reflex pathways to the atonic bladder after conus medullaris injury: preliminary clinical results. Microsurgery 2008, 28(6):429-435.
[138]
Brunelli G, von Wild K. Unsuspected plasticity of single neurons after connection of the corticospinal tract with peripheral nerves in spinal cord lesions. J Korean Neurosurg Soc 2009, 46(1): 1-4.
[139]
Bertelli JA, Ghizoni MF. Nerve transfers for restoration of finger flexion in patients with tetraplegia. J Neurosurg Spine 2017, 26(1): 55-61.
[140]
Yu BF, Qiu YQ, Du MX, et al. Contralateral hemi-fifth-lumbar nerve transfer for unilateral lower limb dysfunction due to incomplete traumatic spinal cord injury: a report of two cases. Microsurgery 2020, 40(2): 234-240.
[141]
Ding WB, Zhang SC, Wu DJ, et al. Hand function recovery using nerve segment insert grafting in patients with chronic incomplete lower cervical spinal cord injury: a preliminary clinical report. J Neurorestoratology 2019, 7(3): 129-135.
[142]
Harkema S, Gerasimenko Y, Hodes J, et al. Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: a case study. Lancet 2011, 377(9781):1938-1947.
[143]
Soler MD, Kumru H, Pelayo R, et al. Effectiveness of transcranial direct current stimulation and visual illusion on neuropathic pain in spinal cord injury. Brain 2010, 133(9): 2565-2577.
[144]
Kern H, Carraro U, Adami N, et al. One year of home-based daily FES in complete lower motor neuron paraplegia: recovery of tetanic contractility drives the structural improvements of denervated muscle. Neurol Res 2010, 32(1): 5-12.
[145]
Ho CH, Triolo RJ, Elias AL, et al. Functional electrical stimulation and spinal cord injury. Phys Med Rehabil Clin N Am 2014, 25(3): 631-654.
[146]
Stabingas K, Bergman J, Patterson M, et al. Peripheral subcutaneous field stimulation for the treatment of spinal cord injury at-level pain: case report, literature review, and 5-year follow-up. Heliyon 2020, 6(7): e04515.
[147]
Gill M, Linde M, Fautsch K, et al. Epidural electrical stimulation of the lumbosacral spinal cord improves trunk stability during seated reaching in two humans with severe thoracic spinal cord injury. Front Syst Neurosci 2020, 14: 79.
[148]
Peña Pino I, Hoover C, Venkatesh S, et al. Long-term spinal cord stimulation after chronic complete spinal cord injury enables volitional movement in the absence of stimulation. Front Syst Neurosci 2020, 14: 35.
[149]
Wood H. Neural repair and rehabilitation: Achieving complex control of a neuroprosthetic arm. Nat Rev Neurol 2013, 9(2): 62.
[150]
Collinger JL, Wodlinger B, Downey JE, et al. High-performance neuroprosthetic control by an individual with tetraplegia. Lancet 2013, 381(9866): 557-564.
[151]
Ganzer PD, Colachis SC 4th, Schwemmer MA, et al. Restoring the sense of touch using a sensorimotor demultiplexing neural interface. Cell 2020, 181(4): 763-773.e12.
[152]
Louie DR, Eng JJ, Lam T, et al. Gait speed using powered robotic exoskeletons after spinal cord injury: a systematic review and correlational study. J Neuroeng Rehabil 2015, 12: 82.
[153]
Rojek A, Mika A, Oleksy Ł, et al. Effects of exoskeleton gait training on balance, load distribution, and functional status in stroke: a randomized controlled trial. Front Neurol 2020, 10: 1344.
[154]
Swank C, Almutairi S, Wang-Price S, et al. Immediate kinematic and muscle activity changes after a single robotic exoskeleton walking session post-stroke. Top Stroke Rehabil 2020, 27(7): 5033-515.
[155]
Huang HY, Chen L, Wang HM, et al. Influence of patients’ age on functional recovery after transplantation of olfactory ensheathing cells into injured spinal cord injury. Chin Med J (Engl) 2003, 116(10): 1488-1491.
[156]
Rabinovich SS, Seledtsov VI, Poveschenko OV, et al. Transplantation treatment of spinal cord injury patients. Biomed Pharmacother 2003, 57(9): 428-433.
[157]
Tabakow P, Raisman G, Fortuna W, et al. Functional regeneration of supraspinal connections in a patient with transected spinal cord following transplantation of bulbar olfactory ensheathing cells with peripheral nerve bridging. Cell Transplant 2014, 23(12): 1631-1655.
[158]
Iwatsuki K, Tajima F, Ohnishi YI, et al. A pilot clinical study of olfactory mucosa autograft for chronic complete spinal cord injury. Neurol Med Chir (Tokyo) 2016, 56(6): 285-292.
[159]
Nakhjavan-Shahraki B, Yousefifard M, Rahimi-Movaghar V, et al. Transplantation of olfactory ensheathing cells on functional recovery and neuropathic pain after spinal cord injury; systematic review and meta-analysis. Sci Rep 2018, 8(1): 325.
[160]
Chen HJ, Tan QJ, Xie CJ, et al. Application of olfactory ensheathing cells in clinical treatment of spinal cord injury: meta-analysis and prospect. J Neurorestoratol 2019, 7(2): 70-81.
[161]
Kang KS, Kim SW, Oh YH, et al. A 37-year-old spinal cord injured female patient, transplanted of multipotent stem cells from human UC blood, with improved sensory perception and mobility, both functionally and morphologically: a case study. Cytotherapy 2005, 7(4): 368-373.
[162]
Chernykh ER, Stupak VV, Muradov GM, et al. Application of autologous bone marrow stem cells in the therapy of spinal cord injury patients. Bull ExpBiol Med 2007, 143(4): 543-547.
[163]
Ra JC, Shin IS, Kim SH, et al. Safety of intravenous infusion of human adipose tissue-derived mesenchymal stem cells in animals and humans. Stem Cells Dev 2011, 20(8): 1297-1308.
[164]
Bhanot Y, Rao S, Ghosh D, et al. Autologous mesenchymal stem cells in chronic spinal cord injury. Br J Neurosurg 2011, 25(4): 516-522.
[165]
Mendonça MV, Larocca TF, de Freitas Souza BS, et al. Safety and neurological assessments after autologous transplantation of bone marrow mesenchymal stem cells in subjects with chronic spinal cord injury. Stem Cell Res Ther 2014, 5(6): 126.
[166]
Yang Y, Pang M, Du C, et al. Repeated subarachnoid administrations of allogeneic human umbilical cord mesenchymal stem cells for spinal cord injury: a phase 1/2 pilot study. Cytotherapy 2021, 23(1): 57-64.
[167]
Deda H, Inci MC, Kürekçi AE, et al. Treatment of chronic spinal cord injured patients with autologous bone marrow-derived hematopoietic stem cell transplantation: 1-year follow-up. Cytotherapy 2008, 10(6): 565-574.
[168]
Al-Zoubi A, Jafar E, Jamous M, et al. Transplantation of purified autologous leukapheresis-derived CD34+ and CD133+ stem cells for patients with chronic spinal cord injuries: long-term evaluation of safety and efficacy. Cell Transplant 2014, 23(Suppl 1): S25-S34.
[169]
Kumar AA, Kumar SR, Narayanan R, et al. Autologous bone marrow derived mononuclear cell therapy for spinal cord injury: A phase I/II clinical safety and primary efficacy data. Exp Clin Transplant 2009, 7(4): 241-248.
[170]
Zhu H, Poon W, Liu YS, et al. Phase I-II clinical trial assessing safety and efficacy of umbilical cord blood mononuclear cell transplant therapy of chronic complete spinal cord injury. Cell Transplant 2016, 25(11): 1925-1943.
[171]
Saberi H, Firouzi M, Habibi Z, et al. Safety of intramedullary Schwann cell transplantation for postrehabilitation spinal cord injuries: 2-year follow-up of 33 cases. J Neurosurg Spine 2011, 15(5): 515-525.
[172]
Zhou XH, Ning GZ, Feng SQ, et al. Transplantation of autologous activated Schwann cells in the treatment of spinal cord injury: six cases, more than five years of follow-up. Cell Transplant 2012, 21(Suppl 1): S39-S47.
[173]
Kanno H, Pearse DD, Ozawa H, et al. Schwann cell transplantation for spinal cord injury repair: its significant therapeutic potential and prospectus. Rev Neurosci 2015, 26(2): 121-128.
[174]
Shroff G. Magnetic resonance imaging tractography as a diagnostic tool in patients with spinal cord injury treated with human embryonic stem cells. Neuroradiol J 2017, 30(1): 71-79.
[175]
Oh SK, Choi KH, Yoo JY, et al. A phase III clinical trial showing limited efficacy of autologous mesenchymal stem cell therapy for spinal cord injury. Neurosurgery 2016, 78(3): 436-447.
[176]
Wang S, Lu JK, Li YA, et al. Autologous olfactory lamina propria transplantation for chronic spinal cord injury: three-year follow-up outcomes from a prospective double-blinded clinical trial. Cell Transplant 2016, 25(1): 141-157.
[177]
Xiao ZF, Tang FW, Zhao YN, et al. Significant improvement of acute complete spinal cord injury patients diagnosed by a combined criteria implanted with NeuroRegen scaffolds and mesenchymal stem cells. Cell Transplant 2018, 27(6): 907-915.
[178]
Zhao YN, Tang FW, Xiao ZF, et al. Clinical study of NeuroRegen scaffold combined with human mesenchymal stem cells for the repair of chronic complete spinal cord injury. Cell Transplant 2017, 26(5): 891-900.
[179]
Huang HY, Sharma H, Chen L, et al. Review of clinical neurorestorative strategies for spinal cord injury: exploring history and latest progresses. J Neurorestoratology 2018, 6: 171-178.
[180]
Oraee-Yazdani S, Hafizi M, Atashi A, et al. Co-transplantation of autologous bone marrow mesenchymal stem cells and Schwann cells through cerebral spinal fluid for the treatment of patients with chronic spinal cord injury: safety and possible outcome. Spinal Cord 2016, 54(2): 102-109.
[181]
Bohbot A. Olfactory ensheathing glia transplantation combined with LASERPONCTURE in human spinal cord injury: Results measured by electromyography monitoring. Cell Transplant 2010, 19(2): 179-184.
[182]
Moviglia GA, Fernandez Viña R, Brizuela JA, et al. Combined protocol of cell therapy for chronic spinal cord injury. Report on the electrical and functional recovery of two patients. Cytotherapy 2006, 8(3): 202-209.
[183]
Ichim TE, Solano F, Lara F, et al. Feasibility of combination allogeneic stem cell therapy for spinal cord injury: a case report. Int Arch Med 2010, 3: 30.
[184]
Donati AR, Shokur S, Morya E, et al. Long-term training with a brain-machine interface-based gait protocol induces partial neurological recovery in paraplegic patients. Sci Rep 2016, 6: 0383.
[185]
Angeli CA, Boakye M, Morton RA, et al. Recovery of over-ground walking after chronic motor complete spinal cord injury. N Engl J Med 2018, 379(13): 1244-1250.
[186]
Gill ML, Grahn PJ, Calvert JS, et al. Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia. Nat Med 2018, 24(11): 1677-1682.
[187]
Abeynayake N, Arthur A, Gronthos S. Crosstalk between skeletal and neural tissues is critical for skeletal health. Bone 2021, 142: 115645.
[188]
Frotzler A, Krebs J, Göhring A, et al. Osteoporosis in the lower extremities in chronic spinal cord injury. Spinal Cord 2020, 58(4): 441-448.
[189]
Lin T, Tong W, Chandra A, et al. A comprehensive study of long-term skeletal changes after spinal cord injury in adult rats. Bone Res 2015, 3: 15028.
[190]
Soleyman-Jahi S, Yousefian A, Maheronnaghsh R, et al. Evidence-based prevention and treatment of osteoporosis after spinal cord injury: a systematic review. Eur Spine J 2018, 27(8): 1798-1814.
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Publication history

Received: 04 February 2021
Revised: 02 March 2021
Accepted: 03 March 2021
Published: 09 June 2021
Issue date: March 2021

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© The authors 2021

Acknowledgements

We should thank Dr. Yulong Wang, Fengzhao Zhu and Lian Zeng for their data search and language polishing, and thank Prof. Qixin Zheng, Yijun Bao for their helpful suggestion.

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