Spinal Cord Injury: Rehabilitation and Stem Cell Therapy Research

What is a spinal cord injury?

A spinal cord injury (SCI) is damage to the bundle of nerves in the spine that carries messages between the brain and the body. It can be caused by trauma, such as road accidents, falls, diving or sports injuries, or by non-traumatic causes such as tumours, infections, blood vessel problems or severe spinal stenosis. The US National Institute of Neurological Disorders and Stroke provides a spinal cord injury overview.

Effects of spinal cord injury

The effects depend on the level and completeness of the injury:

• Tetraplegia (injury in the neck): affects arms, trunk, legs and often breathing
• Paraplegia (injury lower down): affects the trunk and legs
• Complete injury: no movement or feeling below the level
• Incomplete injury: some movement or feeling preserved

Other effects include bladder and bowel dysfunction, sexual dysfunction, nerve pain, spasticity, pressure sores, blood pressure changes (including autonomic dysreflexia in higher injuries) and emotional challenges.

Diagnosis and classification

Assessment	What it shows
MRI of the spine	Cord damage, swelling, bleeding, compression
CT scan	Bone fractures and alignment
ASIA Impairment Scale (A to E)	Grades completeness: A = complete, E = normal
Neurological level	The lowest segment with normal function
Urodynamics, bladder scans	Bladder function

Your MRI and ASIA grade are the most important information for any treatment decision. You can send your MRI reports and rehab notes for a doctor review.

Standard treatment and rehabilitation

1. Emergency care. Spine immobilisation, blood pressure support and, where needed, early surgical decompression and stabilisation.
2. Specialist spinal injury rehabilitation. Physiotherapy, occupational therapy, wheelchair and mobility training.
3. Bladder, bowel and skin management to prevent infections and pressure sores.
4. Spasticity treatment. Stretching, medicines such as baclofen, botulinum toxin, intrathecal baclofen pumps.
5. Nerve pain management. Pregabalin, gabapentin and other approaches.
6. Activity-based therapies. Locomotor training, functional electrical stimulation.
7. Spinal cord stimulation. Research and newer devices pairing stimulation with intensive rehab have helped some people with chronic SCI. The FDA authorised a non-invasive spinal cord stimulation system for upper-limb function in 2024.
8. Psychological support and peer support.

Stem cell therapy for spinal cord injury: the evidence

Researchers have tested many cell types, including mesenchymal stromal cells (MSCs), olfactory ensheathing cells, Schwann cells, neural stem cells and oligodendrocyte progenitors. The main goals are to reduce inflammation and scarring, protect surviving nerve fibres, and support myelin repair.

Study / product	Approach	Finding
CELLTOP, Mayo Clinic (Bydon et al., Nature Communications, 2024)	Phase 1, adipose-derived MSCs into spinal fluid, 10 patients	No serious treatment-related adverse events; improvement in some patients; uncontrolled
Stemirac (Japan, conditional approval 2018)	IV autologous bone marrow MSCs in subacute SCI	Approved on limited, uncontrolled data; criticised by researchers
Embryonic stem cell–derived oligodendrocyte progenitors (US)	Cells injected into the cord	Acceptable safety; trials stopped or not expanded
Various MSC trials (Asia, Europe)	IV, intrathecal or direct injection	Mainly safety data; inconsistent functional results

Overall, systematic reviews describe the evidence as early-stage and low quality. Most studies are small, lack control groups and vary widely in cell type, dose and timing.

Stem cell therapy for SCI should be viewed as experimental. Exosome therapy is being studied in animals for nerve repair but has very little human data.

Regulatory status

No stem cell product is approved for spinal cord injury in the US, UK or Australia. The FDA warns about unapproved stem cell therapies, including serious complications reported from clinics offering spinal injections. Families in the US, UK and Australia should check ClinicalTrials.gov for trials first.

Who may be a candidate, and who should not

May be considered for review:

• Spinal cord injury that is medically stable, usually after initial rehabilitation
• Incomplete injury, or a strong interest in an experimental option with full understanding of uncertainty
• Engaged in ongoing rehabilitation
• Able to travel safely with appropriate support

Should not:

• Recent injury still in acute care
• Unstable spine or unrepaired fractures
• Active infections, including urinary infections or pressure sores
• Uncontrolled autonomic dysreflexia
• Active cancer or pregnancy
• Anyone expecting a guaranteed return of walking

Risks

• Headache, fever or back pain after intrathecal injection
• Infection, including meningitis (rare)
• Bleeding
• Worsening nerve pain or spasticity
• Rare serious complications with direct spinal injections, including tumour-like growths reported from unregulated clinics
• Travel risks: pressure sores, blood clots, bladder infection, heat stress

Cells are prepared in ISO 9001:2015-certified partner laboratories.

What a Bangkok program looks like

1. Send your records. Spinal MRI reports, ASIA assessment, surgery notes, rehab summary and medication list.
2. Doctor review. An honest view of what is realistic.
3. Assessment in Bangkok. Neurological examination, skin and bladder checks, blood tests.
4. Treatment plan, if suitable, combined with physiotherapy sessions.
5. Report for your spinal rehab team.

See how it works for accessible travel planning. Related: multiple sclerosis and stroke recovery.

Aftercare

• Continue your rehabilitation programme daily
• Keep up bladder, bowel and skin routines, especially while travelling
• Report fever, severe headache or new weakness promptly
• Track changes with your rehab team using standard assessments
• Stay realistic: any change, if it occurs, may be small and gradual

Sources

• NINDS: Spinal Cord Injury
• Bydon M, et al. Intrathecal delivery of adipose-derived mesenchymal stem cells in traumatic spinal cord injury: phase I trial. Nature Communications, 2024.
• Cyranoski D. Japan’s approval of stem-cell treatment for spinal-cord injury concerns scientists. Nature, 2019.
• U.S. FDA: Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes