Clinical trials for the treatment of spinal cord injury: cervical and lumbar enlargements versus thoracic area

Sir, Mackay-Sim et al . (2008) evaluated the 3 year safety and efficacy of olfactory ensheathing cells (OEC) transplantation in three complete mid-thoracic spinal cord injured (SCI) patients and compared it with three control cases of SCI.In this letter, we will discuss the safety, efficacy and availability of SCI improvement with regard to cell transplantation in human studies.In terms of safety, the thoracic spinal cord is preferred level of study. The thoracic vertebrae are supported by the rib cage. Thus, motion and instability is less than the cervical and thoracolumbar junction and the stability of the thoracic spine provides less variability in the extent of spinal cord movement. The mid-thoracic area is the best level of study because if the procedure is complicated with say syrinx formation, there is a large distance from the cervical area and therefore cell transplantation leading to nearby damage is less likely. Any ascending damage to one or two spinal cord segments will be of less consequence in the mid-thoracic area than in the cervical region (Feron et al ., 2005).Regarding the ability to evaluate the efficacy of treatment, the mid-thoracic region is the most difficult to evaluate. In cases of small caudal improvement …