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Whether we should wait till spinal shock is over to classify patient as complete or start treating aggressively presuming it to be ASIA A
In second situation after procedure of omentum transposition along with stabilization doubts persist about recovery as critics cite it natural recovery as lesion may not be complete not complete. In our opinion if the lesion is severe on MRI one should opt for option 2.
Possible damage to intact tissue during scar reduction hence this procedure is not recommended as routine only as a last resort
It is better to offer safe and promising option then making patient wait to die. However human transplantation therapy should only be offered after rigorously performed safety studies.
Before moving to human therapy issues which should be addressed
1. Accessible source of cells \tissue
2. Functional benefits therapeutic impact,
3. Migration of the transplanted cells (distance),
4. Active principles of the transplants,
5. long-term safety and efficacy
The most important is participation in invasive surgical interventions for SCI should not disallow their participation in any future clinical trial of a biologic therapy
There are those who would call for an evaluation of any proposal by initiating controlled clinical studies on acutely injured spinal cord patients. Such studies, however, would be extremely difficult, if not impossible, to carry out since all high-impact spinal cord injuries are different; and obtaining sufficient numbers of experimental and control patients for these studies would be difficult
It is proposed to choose ASIA A/B SCI patients, which are further classified on mri basis and time window or treatment since the condition of these patients rarely results in functional recovery.
If a significant number of such patients subjected to this treatment protocol demonstrated functional return on comparing patients with similar level of severity of injury and time window, this would be of high clinical importance.
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