Clinical efficacy of bone marrow mesenchymal stem cells in chronic spinal cord injury: A single-arm meta-analysis of clinical trials

  • Dewa Putu Wisnu Wardhana Neurosurgery Division, Department of Surgery, Faculty of Medicine, Universitas Udayana, Universitas Udayana Hospital, Badung, Bali, Indonesia
  • Cindy Thiovany Soetomo Faculty of Medicine, Universitas Udayana, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia
  • Agung Bagus Sista Satyarsa Neurosurgery Division, Surgery Department, Faculty of Medicine, Universitas Udayana, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia
  • Sri Maliawan Neurosurgery Division, Surgery Department, Faculty of Medicine, Universitas Udayana, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia
  • Tjokorda Gde Bagus Mahadewa Neurosurgery Division, Surgery Department, Faculty of Medicine, Universitas Udayana, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia
DOI: https://doi.org/10.51559/ptji.v6i2.318
Keywords: Bone Marrow Mesenchymal Stem Cells, Chronic Spinal Cord Injury, Neurological Recovery, Urodynamic Function

Abstract

Background: Chronic spinal cord injury (SCI) leads to irreversible neurological deficits with limited therapeutic options, making it a major challenge in neuroregenerative medicine. This study aimed to evaluate the clinical efficacy of bone marrow mesenchymal stem cells (BMMSC) therapy in patients with chronic SCI using a single-arm meta-analysis.

Methods: This research was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, covering studies up to August 2024 in PubMed, CENTRAL, and ScienceDirect. Included trials applied BMMSC therapy in patients ≥1 year post-injury. A random-effects model was employed using R software. Outcomes included changes in the American Spinal Injury Association (ASIA) impairment scale, somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), infralesional voluntary muscle contraction (IVMC), active muscle reinnervation (AMR), and urodynamic parameters. Heterogeneity was assessed with the I² statistic, and study quality was evaluated via ROBINS-I. This study has been registered on PROSPERO with registration number CRD42024577161.

Results: Seven studies comprising 133 patients were included. AIS grade improvement was observed in 0.37 (95% CI: 0.24–0.52). Improvements were also seen in SSEP at 0.40 (95% CI: 0.18–0.67), MEP at 0.37 (95% CI: 0.25–0.51), IVMC at 0.47 (95% CI: 0.34–0.60), and AMR at 0.74 (95% CI: 0.39–0.92). Urodynamic outcomes demonstrated increased maximum cystometric capacity [0.48 (95% CI: 0.30–0.67)], improved bladder compliance [0.73 (95% CI: 0.55–0.85)], and reduced detrusor pressure [0.61 (95% CI: 0.43–0.76)].

Conclusion: BMMSC therapy was associated with clinically meaningful neurological and urodynamic improvements in chronic SCI. Standardized administration protocols and randomized controlled trials are necessary to validate efficacy and optimize treatment paradigms.

Author Biographies

Dewa Putu Wisnu Wardhana, Neurosurgery Division, Department of Surgery, Faculty of Medicine, Universitas Udayana, Universitas Udayana Hospital, Badung, Bali, Indonesia

Neurosurgery Division, Department of Surgery, Faculty of Medicine, Universitas Udayana, Universitas Udayana Hospital, Badung, Bali, Indonesia

Cindy Thiovany Soetomo, Faculty of Medicine, Universitas Udayana, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia

Faculty of Medicine, Universitas Udayana, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia

Agung Bagus Sista Satyarsa, Neurosurgery Division, Surgery Department, Faculty of Medicine, Universitas Udayana, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia

Neurosurgery Division, Surgery Department, Faculty of Medicine, Universitas Udayana, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia

Sri Maliawan, Neurosurgery Division, Surgery Department, Faculty of Medicine, Universitas Udayana, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia

Neurosurgery Division, Surgery Department, Faculty of Medicine, Universitas Udayana, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia

Tjokorda Gde Bagus Mahadewa, Neurosurgery Division, Surgery Department, Faculty of Medicine, Universitas Udayana, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia

Neurosurgery Division, Surgery Department, Faculty of Medicine, Universitas Udayana, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia

Published
2025-09-26
Issue
Vol. 6 No. 2 (2025): Inpress July-December 2025
Section
Articles