Role of stem cells transplantation for patients with spinal cord injury: systematic meta-analysis

Abstract

Background: Spinal cord injury is a devastating condition that leads to physical, social, and vocational impairment due to the irreversible loss of neural function below the injury site. The objective of this study is to investigate the efficacy and safety of bone marrow mononuclear cells (BM-MNCs) transplant in patients with spinal cord Injury in systematic meta-analysis. Methods: This systematic review and meta-analysis study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The authors searched the PubMed, Web of Science, Cochrane, and Embase databases, OVID, China Biomedical Database (CBM), SinoMed databases and Library databases up to March 15, 2022. Inclusion criteria included for quantitative review, two well-trained author's retrieved independently relevant data from articles included for analysis and cross-checked it. In case of disagreements, a third party was consulted to reach a consensus. The methodological quality of the included studies was assessed independently by two reviewers using the Cochrane Collaboration's ROBINS-I tool for non-randomized studies. Results: Preliminary search database resulted in 549 articles, finally, after excluded all articles did not meet the study criteria 26 studies were included in study and 569 Spinal cord injury patients were included for qualitative analysis in this meta-analysis. Male 77.9% with male/female ration 485/84 variability in the age among included studies. Resulted data showed minor adverse events after bone marrow mononuclear cells (BM-MNCs) transplant; low heterogeneity was observed across each trial (P = 0.11, I2 = 38%). The average risk ratio of these studies was 10.12 (95%CI: 4.24-29.12, p < 0.00003) without heterogeneity (p = 0.81, I2 = 0%) between studies. The methodological quality of the included studies used the standard Cochrane Collaboration tool to analysis is the risk of bias. Conclusions: Bone marrow mononuclear cells (BM-MNCs) significantly improve neurological function in patients with spinal cord injury. Furthermore, this type of procedures has no systemic nor serious complications after autologous transplantation.