Davonta
- Spinal Cord Injury (SCI),
- L1, Complete
Stem Cells, LamiSpine
- Name:Davonta
- Age at Time of Treatment:26 - 35
- Sex:Male
- Nationality:American
- Treatment Location:Thailand
- Diagnosis on Admission:Spinal Cord Injury (SCI)
- Injury Level:L1, Complete
- Time Since Injury:Less than 1 year
- ASIA Before Treatment:C
- ASIA After Treatment:C
- Treatment Received:Stem Cells, LamiSpine
- Date of Admission:28/07/2024
- Date of Discharge:21/08/2024
Patient Overview
Patient Condition on Admission
Davonta suffered from a traumatic spinal cord injury at the thoracic level, more specifically, at the T11/L1 level back in 2023. He experiences nerve pain and can not feel anything in his legs and feet. Davonta spent 1 month at Shirley Ryan Ability Lab rehabilitation center.
Treatment Received
Davonta was evaluated for and accepted into a treatment protocol involving LamiSpine surgery where he received intraspinal cord injections of human amniotic fluid stem cells directly in and around the injury. Furthermore, as part of the regenerative medicine treatment, he received one intravenous injection of mesenchymal stem cells and one lumbar puncture injection of human amniotic fluid stem cells.
Stem Cells Treatment Summary
| LamiSpine/ Stem cells treatment | Number of stem cells | Delivery method |
|---|---|---|
| Amniotic Fluid Stem Cells (AFSC) | 80 million cells | LamiSpine injection |
| Mesenchymal Stem Cells type 2 | 40 million cells | Intravenous injection (IV injection) |
| Amniotic Fluid Stem Cells (AFSC) | 30 million cells | Lumbar Puncture injection (LP injection) |
Device Mapping and Therapy
| Post-surgical care | Total sessions | Sessions per week | Time (Hr.) per session |
|---|---|---|---|
| Physical Therapy | 16 | 5 | 1 |
| ABT - LT (Activity Based Training and Locomotor Training) | 32 | 10 | 1 |
| PAS (Paired Associative Stimulation) | 18 | 5 | 1 |
| Total sessions of rehabilitation | 66 |
Muscle Power Improvement Post-Surgery
Lower Body
| Muscle improvement | Before LS surgery | At discharge |
|---|---|---|
| Hip flexors | 2 | 2+ |
| Hip extensors | 1 | 2 |
| Hip abductors | 1 | 1+ |
| Hip adductors | 1 | 1+ |
| Knee extensors | 1 | 2 |
| Knee flexors | 1 | 2 |
| Ankle dorsiflexors | 1 | 1 |
| Ankle plantarflexors | 1 | 1+ |
| Long toe extensors | 1 | 1 |
Muscle power improvement was assessed according to the Manual Muscle Testing (MMT) protocol on the patient’s discharge date, with the stimulator on. 0 indicates total paralysis, 1 indicates visible contraction, 2 indicates active movement, full range of motion (ROM) with gravity eliminated, 3 indicates active movement, full ROM against gravity, 4 indicates active movement, full ROM against gravity and moderate resistance in a muscle-specific position, and 5 (normal) indicates active movement, full ROM against gravity, and moderate resistance in a muscle-specific position expected from an unimpaired person.
Functional Improvement Post-Surgery
Motor Function
| Abilities & Symptoms | Before LS surgery | At discharge |
|---|---|---|
| Standing with support | Dependent (KAFO, minimal assist with hip and knee locking) | Dependent (without KAFO, minimal assist with knee locking) |
| Stepping with support (for more than 100 meters) | Possible (with KAFO and walker) | Independent (with mirror and KAFO) |
| Standing balance | Fair | Good |
| Sitting balance | Good | Normal |
| Motor coordination (while stepping) | Moderate assist | Independent |
| Sit to stand (in a walker) | Minimal assist | Independent |
| Ability to transfer | Independent | Independent |
| Ability to use abdominal muscles during bowel program | Absent | Dependent (with caregiver support) |
| Stamina & Fatigue | Fair (30reps, walk 50 meters) | Good (50 reps, walk 125 meters) |
| Spasticity | Present | No change |
Sensory Function
| Abilities & Symptoms | Before LS surgery | At discharge |
|---|---|---|
| Neuropathic pain | Present | Absent |
| Temperature sensations | Absent | No change |
| Proprioception | Absent | No change |
| Bladder sensation | Absent | No change |
| Bowel sensation | Absent | No change |
Autonomic Function
| Abilities & Symptoms | Before LS surgery | At discharge |
|---|---|---|
| Sweating ability | Blood Pressure Regulation | Present (below level of injury) |
| Temperature regulation | Normal | Normal |
| Blood pressure regulation | Normal | Normal |
Motor Funtions
89%
Sensory Funtions
20%
Autonomic Function
100%
Overall
67%
Improvements are monitored in 18 targeted areas: 9 Motor areas, 5 Sensory areas and 3 autonomic 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. No improvement, the existence of pain or spasms, or an inability to perform a measured function is reported as negative.
*According to the Functional Balance Grades, ‘Absent’ indicates that the patient is unable to perform a particular activity or function. ‘Poor’ indicates that the patient requires support and moderate to maximal assistance for a particular activity or function. ‘Fair’ indicates that the patient is able to perform a particular activity or function with minimal assistance. ‘Good’ indicates that the patient is able to perform a particular activity or function and can accept moderate challenge. ‘Normal’ indicates that the patient can perform a particular activity or function without any support.
Results Intrepretation
Motor Function
Following the Lamispine surgery, Davonta started to experience muscle contractions for the first time since his injury. He started to regain voluntary muscle contractions in his glutes, hip muscles, and quadriceps. His muscle tone, which had been flaccid since the injury, started to recover. He was able to regain partial control over his hip muscles and was able to perform walking using his hip muscles.
Sensory Function
Immediately after the injury Davonta started to regain feelings in various parts of his legs. The early feelings came back in the form of tingling sensations and pins and needles indicating a potential future recovery of more pronounced sensory functions. He also reported improvements in his pain score and was able to sleep, for the first time since his injury, without waking up due to excruciating pain.
Autonomic Function
No changes at the time of discharge
Sitting
His static sitting balance was already good however his dynamic sitting balance started to improve.
Standing
Using a walking frame he was able to stand and remain in standing position for extended periods of time.
Case Summary
Back in 2023, Davonta had suffered a traumatic spinal cord injury around the T11-L1 level. As a result, he can’t feel his legs or feet. When he came to us, he received Verita Neuro’s flagship LamiSpine surgery. This surgery is where purified and cultured populations of amniotic fluid stem cells were carefully transplanted into the injured spinal cord. Additionally, he received one intravenous injection of Mesenchymal Stem Cells type 2 and one lumbar puncture injection of amniotic fluid stem cells.
Overall, Davonta reported improvements in both areas, motor function, and sensory function. He had a flaccid muscle tone with floppy paraplegia after the injury which indicated the major loss of lower motor neuron populations in the lumbar spinal cord. After the treatment he started to regain muscle tone, muscle contractions and voluntary muscle control and for the first time, since his injury, he was able to produce voluntary movements in his lower limbs. He also started to perform standing and walking training and dynamic sitting balance training.
In terms of his sensory function, it started to return in the form of pins and needles and tingling sensations.