Case Study

Patient E,

Female, Italian

Table of Contents

Patient Overview

Age at time of treatment: 36 – 45
Injury Level: T7
Treatment Received: Stem Cells, Epidural Stimulation
Location of Treatment: Thailand
Time between injury and treatment: —
Date of Surgery: 07/07/2018
Date of Discharge: 09/08/2018

Condition on Admission

Patient sustained fracture and bursting of T7 with 12mm rear wall displacement. Her MRI scan showed T7 fracture-dislocation with subsequent spinal cord contusion and myelomalacia (spinal cord softening). Patient has complete paraplegia with no residual motor or sensory functions below the injury level, but is independent in her daily activities. Patient suffers from neurogenic bladder and bowel.

Previous Therapies & Treatments

Patient has participated in various rehabilitation programs, including ones for strengthening her upper extremities and improving ambulation and trunk control.

Patient sustained fracture and bursting of T7 with 12mm rear wall displacement. Her MRI scan showed T7 fracture-dislocation with subsequent spinal cord contusion and myelomalacia (spinal cord softening). Patient has complete paraplegia with no residual motor or sensory functions below the injury level, but is independent in her daily activities. Patient suffers from neurogenic bladder and bowel.

Verita Neuro Treatment Received

After a spinal MRI scan and comprehensive blood work, patient underwent laminectomy and implantation of the epidural stimulation device on July 7, 2018. The device is the ‘Medtronic Restore Advance 16-electrode MRI Compatible Device’. The surgery was completed without issue and no complications were reported during the postoperative hospital stay. Surgical wounds healed normally and no spinal cord or superficial wound infection was reported.

After epidural stimulation surgery, patient received 90 mapping sessions and 27 physical therapy sessions. Patient also received 120 million Stem cells, 40 million Mesenchymal Stem cells and 80 million Amniotic Fluid Stem Cells (hAFSCs) through one IV injection and two lumbar puncture injections, respectively. All three applications went well without adverse effects and no short-term or acute complications have been reported.

Mapping began two days after surgery and good voluntary muscle contraction was observed. Therapy was halted by a severe urinary tract infection and recurrent fever for which the patient was treated with a prolonged course of IV antibiotics. She completely recovered towards the end of the post-surgical therapy (35 days).

After recovery, new mapping sessions were begun and eventually voluntary muscle control started to come back, with standing and stepping training during the last week of the treatment.

Patient-E Verita Neuro Treatment Received

Results

Patient’s gross motor skills improved slightly. Patient is able to move her legs, and can move the left better than the right. Improvement was seen in hip flexion, but ankle flexion is observed in the left ankle only. Patient is able to lift her feet slightly.


Patient has good static sitting balance, but dynamic sitting balance requires minimal assistance. Patient has good static and dynamic standing balance with minimal support. Muscle mass has increased and endurance has improved. Patient is able to stand at the parallel bar and is able to lock both knees, but her left knee locks better than the right. Patient has good trunk control and is able to lock her hips while standing and bears weight equally on both legs.

Patient uses a walking frame when taking assisted steps, but requires assistance with foot placement and is unable to lock her knees. Patient is able to coordinate both legs during her stepping exercises.
N/A
Two mapping programs have reduced flexor spasms the patient experiences during sleep: one is conducted 2 hours before sleep and the other occurs overnight.

There was no noticeable improvement to her neurogenic bladder and bowel. Patient received stem cell injections, therefore we expect to see results in these areas within 3 months time.

Patient-E Other Results

Improvements are monitored in 15 targeted areas: 11 Motor areas and 4 Sensory areas. However, the number of targeted areas may vary depending on patient’s condition prior to admission. If patient does not experience symptoms in certain Motor/Sensory functions, or is not impaired in a specific targeted area prior to surgery, it is excluded from the report (Not Applicable). If there is progress in any given area — either mild, moderate, or significant — it is measured and reported as positive (“Yes”). No improvement, the existence of pain or spasms, or an inability to perform a measured function is reported as “No”.

Results Interpretation

As the patient is paraplegic with normal upper limb function, improvement in fine motor skills was considered “not applicable”. Motor function improved in 10 out of 10 targeted areas when the epidural stimulation device was switched on. Patient has not experienced any changes in sensory function, but more feedback will be collected after 3 months to note any improvements from stem cell treatment. Improvements were recorded in 10 out of 14 targeted motor and sensory function areas.

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All medical treatments have varied outcomes. Results from the treatments will vary from patient to patient. All examples of what has been achieved by others should not be taken as typical or in any way a guarantee or projection of what any individual can expect from treatment.