Case Study

Patient O,

Male, American

Table of Contents

Patient Overview

Age at time of treatment: 18 – 25
Injury Level: C6
Treatment Received: Stem Cells, Epidural Stimulation
Location of Treatment: Thailand
Time between injury and treatment: 2 – 5 years
Date of Surgery: 30/05/2017
Date of Discharge: 08/07/2017

Condition on Admission

Patient sustained a C6 burst fracture that was treated with emergent anterior corpectomy and C5-C7 spinal fusion in October, 2014. Patient noticed improvements from the procedures in core muscles, but is still very weak.

Patient is a C6 incomplete quadriplegic, therefore he has limited fine motor skills, but no motor function in lower limbs. He has minimal sensory functions and suffers from neurogenic bowel and bladder as well as spasms and spasticity. Patient takes Neurontin and Gabapentin for neuropathic pain, but does not feel any relief from the medication.

Previous Therapies & Treatments

Patient received 3 months of inpatient rehabilitation, followed by 18 months of outpatient aqua therapy and locomotor training.

Patient sustained a C6 burst fracture that was treated with emergent anterior corpectomy and C5-C7 spinal fusion in October, 2014. Patient noticed improvements from the procedures in core muscles, but is still very weak.

Patient is a C6 incomplete quadriplegic, therefore he has limited fine motor skills, but no motor function in lower limbs. He has minimal sensory functions and suffers from neurogenic bowel and bladder as well as spasms and spasticity. Patient takes Neurontin and Gabapentin for neuropathic pain, but does not feel any relief from the medication.

Verita Neuro Treatment Received

After a spinal MRI scan and comprehensive blood work, patient underwent laminectomy and implantation of the epidural stimulation device on June 2, 2017. The device is the ‘Medtronic Restore Advance 16-electrode MRI Compatible Device’.  The surgery was completed without significant adverse effects and the surgical wound healed normally. No serious complications were reported during the postoperative hospital stay.

After the epidural stimulation surgery, patient received 46 mapping sessions, 38 physical therapy and 9 occupational therapy sessions. Patient also received 120 million Mesenchymal Stem Cells (MSCs) through three lumbar puncture injections and one IV injection. All four stem-cell treatments went well without adverse effects and no short-term or acute complications have been reported.

Device Mapping and therapy were carried out after surgery for 35 days, then patient was discharged.

Results

Patient’s static sitting and standing balance improved. Patient is able to stand at the parallel bar and is able to lock his knees when doing so, however, he has limited trunk control and weak upper body so he is not able to stand for long periods of time. Patient’s motor function improved, including ankle, knee, and hip flexion, as well as knee extension.

Patient is able to take assisted steps with the use of a hoist and walking frame. Patient is able to lift his feet by himself and his coordination has improved in both legs, but he requires assistance in foot placement and knee locking.
N/A
Patient’s spasms and spasticity are lessened when epidural stimulation device is switched on, but there was no noticeable change in bladder and bowel functions. More feedback needs to be collected on patient’s neuropathic pain.

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

In this patient, 15 of 15 motor and sensory functions were targeted. Overall, improvements were recorded in 11 out of 15 targeted motor and sensory function areas. Motor function improved in 11 out of 11 targeted areas when the epidural stimulation device was switched on, but there were no improvements in sensory function. More feedback will be collected to note any improvements made by the stem cell treatments.