Thariq
- Spinal Cord Injury (SCI),
- L1, Complete
Stem Cells, LamiSpine
- Name:Thariq
- Age at Time of Treatment:18 - 25
- Sex:Male
- Nationality:Indonesian
- Treatment Location:Thailand
- Diagnosis on Admission:Spinal Cord Injury (SCI)
- Injury Level:L1, Complete
- Time Since Injury:Less than 1 year
- ASIA Before Treatment:A
- ASIA After Treatment:D
- Treatment Received:Stem Cells, LamiSpine
- Date of Admission:06/12/2020
Patient Overview
Thoriq sustained a T12 complete spinal cord injury that left him paralyzed from the waist down in 2019. For him, there are no limits to how far he’s willing to push himself to regain the abilities he had before his injury.
Patient Condition on Admission
Thariq sustained a complete L1 traumatic spinal cord injury in August 2020, resulting in paraplegia. The injury caused him to suffer from flaccid muscle tone and muscle atrophy in his lower limbs. He also has neurogenic bowel and bladder dysfunction. Thariq’s previous therapies included reconnecting right-angle surgery and rehabilitation programs. This improved his sitting balance, his ability to use the standing frames, and stretching his stiff muscles. He also underwent lumbar decompression at L1 and T12.
Treatment Received
Thariq was evaluated for and accepted into a treatment protocol involving LamiSpine surgery, during which he received intraspinal cord injections of stem cells directly at or near the site of injury. In the following months of his long-term regenerative medicine treatment plan, he
continues to receive human Amniotic Fluid Stem Cells (hAFSCs) via lumbar puncture injections.
Stem Cells Treatment Summary
| LamiSpine/ Stem cells treatment | Date | Number of stem cells | Delivery method |
|---|---|---|---|
| Amniotic Fluid Stem Cells (AFSCs) | December 2020 | 75 million cells | LamiSpine injection |
| Amniotic Fluid Stem Cells (AFSCs) | December 2020 | 35 million cells | Lumbar puncture injection (LP injection) |
| Mesenchymal Stem Cells (MSCs) | December 2020 | 40 million cells | Intravenous injection (IV injection) |
| Amniotic Fluid Stem Cells (AFSCs) | August 2021 | 70 million cells | Lumbar puncture injection (LP injection) |
| Amniotic Fluid Stem Cells (AFSCs) | December 2021 | 70 million cells | Lumbar puncture injection (LP injection) |
| Amniotic Fluid Stem Cells (AFSCs) | March 2022 | 70 million cells | Lumbar puncture injection (LP injection) |
| Amniotic Fluid Stem Cells (AFSCs) | July 2022 | 70 million cells | Lumbar puncture injection (LP injection) |
| Amniotic Fluid Stem Cells (AFSCs) | November 2022 | 70 million cells | Lumbar puncture injection (LP injection) |
| Amniotic Fluid Stem Cells (AFSCs) | March 2023 | 70 million cells | Lumbar puncture injection (LP injection) |
| Amniotic Fluid Stem Cells (AFSCs) | July 2023 | 70 million cells | Lumbar puncture injection (LP injection) |
| Amniotic Fluid Stem Cells (AFSCs) | Novemebr 2023 | 70 million cells | Lumbar puncture injection (LP injection) |
| Amniotic Fluid Stem Cells (AFSCs) | March 2024 | 70 million cells | Lumbar puncture injection (LP injection) |
Device Mapping and Therapy
| Post-surgical care | Date | Total sessions | Sessions per week | Time (Hr.) per session |
|---|---|---|---|---|
| Physical therapy | 25 days after admission | 34 | 7 | 1 |
| ABT - LT (Activity Based Training and Locomotor Training | 25 days after admission | 19 | 5 | 1 |
| PAS (Paired Associative Stimulation) | 25 days after admission | 17 | 4 | 1 |
| Physical therapy | Extended stay | 1,633 | 13 | 1 |
| ABT - LT (Activity Based Training and Locomotor Training | Extended stay | 2,901 | 20 | 1 |
| PAS (Paired Associative Stimulation) | Extended stay | 698 | 5 | 1 |
Muscle Power Improvement Post-Surgery
Lower Body
| Muscle improvement | Before LS surgery | At discharge (25 days after LS surgery) | 1 year after discharge | 2 years after discharge | Current condition (3.5 years after discharge) |
|---|---|---|---|---|---|
| Hip flexors | 0 | 1 | 2 | 2 | 3 |
| Hip extensors | 0 | 0 | 0 | 1 | 2 |
| Hip abductors | 0 | 0 | 0 | 1 | 2 |
| Hip adductors | 0 | 0 | 0 | 1 | 2 |
| Knee extensors | 0 | 1 | 2 | 2 | 3 |
| Knee flexors | 0 | 1 | 2 | 2 | 3 |
| Ankle dorsiflexors | 0 | 0 | 0 | 0 | 1 |
| Ankle Plantarflexors | 0 | 0 | 0 | 0 | 0 |
| Long toe extensors | 0 | 0 | 0 | 0 | 0 |
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 (25 days after LS surgery) | 1 year after discharge | 2 years after discharge | Current condition (3.5 years after discharge) |
|---|---|---|---|---|---|
| Standing with support | Not possible | No change | Maximum assistance | Moderate assistance | Minimal assistance |
| Stepping with support (for more than 10 meters) | Not possible | No change | Maximum assistance | Moderate assistance | Minimal assistance |
| Standing Balance | Absent * | No change | Maximum assistance | Moderate assistance | Minimal assistance |
| Sitting Balance | Poor * | No change | Fair * | Good * | No change |
| Motor Coordination (while stepping | Poor * | No change | Fair * | Good * | No change |
| Sit to Stand (in a walker) | Poor * | No change | Fair * | Good * | No change |
| Ability to transfer | Poor * | No change | Fair * | Good * | No change |
| Ability to use abdominal muscles during bowel program | Poor * | No change | Fair * | Good * | No change |
| Stamina & Fatigue | Poor * | No change | Fair * | Good * | No change |
| Spasticity | Absent | Absent | Absent | Absent | Absent |
Sensory Function
| Abilities & Symptoms | Before LS surgery | At discharge (25 days after LS surgery) | 1 year after discharge | 2 years after discharge | Current condition (3.5 years after discharge) |
|---|---|---|---|---|---|
| Neuropathic pain | Minimal pain | No change | No change | Moderate pain | No change |
| Temperature sensations | Poor * | No change | Good * | No change | No change |
| Proprioception | Poor * | No change | Fair * | No change | No change |
| **Bladder sensation | Poor * | No change | Fair * | Good * | No change |
| Bowel sensation | Poor * | No change | Fair * | Normal * | Normal * |
Autonomic Function
| Abilities & Symptoms | Before LS surgery | At discharge (25 days after LS surgery) | 1 year after discharge | 2 years after discharge | Current condition (3.5 years after discharge) |
|---|---|---|---|---|---|
| Sweating ability | Poor * | No change | Fair * | Good * | No change |
| Temperature regulation | Normal | Normal | Normal | Normal | Normal |
| Blood pressure regulation | Stable | Stable | Stable | Stable | Stable |
Motor Funtions
100%
Sensory Funtions
100%
Autonomic Function
100%
Overall
100%
Improvements are monitored in 18 targeted areas: 10 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.
**Thariq has achieved significant improvement in his bladder function by removing the use of a catheter. He has gained the ability to initiate voluntary voiding, effectively controlling his pelvic musculature to facilitate independent urination.
Results Intrepretation
Motor Function
Thariq has regained a significant amount of motor function and control in his left leg, moderate motor function, and control in his right leg. He is able to stand, lock his knees, and walk with knee braces. He started as a flaccid paraplegic, but since the treatment, a significant amount of muscle tone has returned, indicating the regeneration of the lower motor neurons in his lumbar spinal cord.
Sensory Function
Thariq regained temperature, superficial, and deep sensations throughout his legs. He is able to feel when he needs to go to the toilet and also able to sense different temperatures. He has regained his proprioception, greatly improving his walking and standing ability.
Autonomic Function
The autonomic components of his bowel, bladder, and sexual functions have greatly improved.
Sitting
His sitting function has improved greatly. He is not only able to sit unassisted without any support but also has an excellent ability to maintain his position even when challenged.
Standing
He can stand, lock his knees, and maintain the standing position for as long as required.
Case Summary
Thariq sustained a severe traumatic spinal cord injury in 2020, resulting in complete paraplegia. Within just a few months of his injury, he lost muscle tone and developed flaccid paraplegia, along with a complete loss of control over his bowel and bladder functions. He received Verita Neuro’s flagship LamiSpine surgery, during which purified and cultured populations of amniotic fluid stem cells were carefully transplanted into the injured spinal cord. Additionally, he received one IV and one lumbar puncture injection of stem cells.
After the surgery, Thariq reported increased levels of neuropathic pain for a few weeks, which were managed with pain medications. There were no other reported side effects post-surgery. The pain levels started to subside, and he began extensive training. After a few weeks, his muscles started to contract again, and his motor function and muscle control began to recover. Since the initial surgery, Thariq has been undergoing physiotherapy and extensive muscle strengthening, resulting in gradual recovery of function. So far, he has recovered more than 80% of the muscles in his lower limbs, with almost complete recovery in his left leg motor function and control, bowel, bladder, and sexual functions, as well as significant recovery in his right leg and sensations.