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Stem Cell Therapy for Spinal Cord Injury

The spinal cord is a column of nerve tissue that connects the brain with the peripheral nerves. Damage to the spinal cord can disrupt this communication, causing severe motor and sensory deficits that may lead to the inability to move or feel.

At ANOVA IRM in Offenbach, Germany, stem cell-based therapy is being explored as part of a regenerative treatment option for selected SCI patients. In collaboration with Cyberdyne Care Robotics, ANOVA offers REMCell, which combines stem cell-based neuro-regeneration with HAL exoskeleton training.

On this page, you will find more information about REMCell treatment and how stem cell therapy is being studied in relation to spinal cord injury. These options are still considered experimental. Outcomes vary from patient to patient, and treatment cannot guarantee restored movement, sensation, or functional recovery. An individual medical review is required to determine eligibility.

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Spinal Cord Injury Treatment Overview

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Patients may be considered for treatment in selected cases involving:

  • Partial or incomplete spinal cord injuries
  • Cervical, thoracic, or lumbar spinal cord injuries
  • Traumatic spinal injury
  • Spinal cord compression
  • Spinal cord edema after surgery
  • Complete spinal cord injury only in selected responsive cases

Stem Cell Therapy for Spinal Cord Injury at ANOVA IRM

Stem cell therapy is not a replacement for established SCI treatment. Surgery, medication, physical therapy, and neuro-rehabilitation remain standard components of treating spinal cord injuries, but they often focus on stabilization and symptom management rather than biological repair.

Conventional neuro-rehabilitation has often been built on two assumptions:

  1. Further functional recovery was not possible during the chronic phase, starting one year after the SCI.
  2. The main problem in SCI patients occurs only at the spinal cord level.

Both assumptions have since been challenged, at least partially. By shifting focus beyond spinal stabilization alone, regenerative medicine at ANOVA IRM explores stem cell-based therapies in relation to inflammatory pathways and biological processes involved in the spinal cord injury environment.

This approach is combined with neuro-functional training through the HAL exoskeleton. Together, these two elements form REMCell, or Robotic Exoskeleton and Mesenchymal Stem Cell Therapy.

Since 2019, ANOVA IRM has offered this approach in collaboration with Cyberdyne Care Robotics, the developer of the HAL robotic exoskeleton.

Can Stem Cell Therapy Help Spinal Cord Injury?

Stem cell therapy for spinal cord injury is still considered experimental. It is not a cure for SCI, and outcomes vary from patient to patient. However, it is being explored because spinal cord injury often involves more than the initial mechanical damage.

In cases of trauma, compression, or fractured vertebrae, secondary damage may also occur in and around the spinal cord. This can involve:

  • Inflammation, bleeding, edema, and swelling
  • Increased pressure inside the spinal canal
  • Reduced blood supply to damaged spinal cord tissue
  • Disrupted axons, demyelination, and glial scarring
  • Loss of neural and supporting cells

These processes can make spinal cord injury difficult to treat with local stabilization alone. Stem cell-based therapies are being studied because they may influence the damaged tissue environment through biological signalling, rather than simply replacing lost nerve cells.

Mesenchymal stem cells and their secretome may release bioactive molecules involved in inflammatory signalling and tissue-response pathways. This is one reason Stem Cell Secretome / Exosome therapy is especially relevant to SCI research.

At the same time, biological signalling may not translate into functional improvement by itself. This is why ANOVA IRM combines stem cell-based neuro-regeneration with neuro-functional rehabilitation through the HAL exoskeleton in selected patients.

ANOVA IRM Treatment Approach for Spinal Cord Injury

At ANOVA IRM, stem cell-based therapies for spinal cord injury are delivered in a regulated German medical setting. Products undergo quality control before treatment and are handled within ANOVA IRM’s controlled medical framework.

We employ only autologous treatment concepts, meaning therapies are based on the patient’s own biological material rather than donor-derived products.

Depending on the type of spinal cord injury, different stem cell types and stem cell-derived products may be considered. Treatment typically involves Mesenchymal Stem Cell Secretome (MSEC), Bone Marrow Concentrate (BMC), or a combination of the two.

What Therapeutic Outcomes Can Be Expected?

Stem cell-based therapy for spinal cord injury is still experimental, and results vary from patient to patient. At ANOVA IRM, the treatment concept is based on reviewing stem cell-based therapy together with neuro-functional rehabilitation.

External pre-clinical research on mesenchymal stem cells and their secretome has explored possible effects on damaged spinal cord tissue, including glial scar remodelling, vascularization, and axonal growth. These mechanisms are one reason MSEC / Secretome therapy is being explored for SCI.

During consultation, patients often ask about goals such as mobility with aids, greater independence, motor function, neuropathic pain, spasticity, sensitivity, and quality of life. These questions are reviewed individually based on the type and severity of injury, remaining nerve signals, overall health, and rehabilitation participation.

Pressure sore risk, sensitivity, mobility, and daily care needs can be discussed as part of the patient’s individual medical review.

While stem cell-based therapy and HAL exoskeleton training may be reviewed together as part of a rehabilitation-focused treatment plan, treatment remains experimental and cannot guarantee restored walking ability, symptom improvement, or full neurological recovery.

Potency Hypothesis of Stem Cell Therapies

Stem cells and their secretome may communicate with the damaged tissue environment, including immune cells. In spinal cord injury, this signalling is being studied in relation to inflammatory pathways and tissue-response processes around damaged tissue.

The goal of stem cell-based therapy is not simply to replace lost nerve cells. Instead, mesenchymal stem cells and their secretome are being explored for their potential to influence biological processes involved in the spinal cord injury environment.

For this reason, ANOVA IRM considers stem cell-based treatment and intensive rehabilitation together when reviewing selected SCI cases.

Mesenchymal Stem Cell Secretome / Exosome Therapy

Mesenchymal Stem Cell Secretome (MSEC) therapy is a cell-free stem cell-derived treatment. Instead of relying on living stem cells, this treatment uses the bioactive molecules released by mesenchymal stem cells, including exosomes, cytokines, proteins, growth factors, miRNA, and microvesicles.

At ANOVA IRM, MSEC is produced from the patient’s own adipose-derived stem cells, which are harvested from abdominal fat tissue through a limited liposuction procedure under light sedation.

Unlike localized BMC therapy, MSEC is administered intravenously as part of the treatment protocol. The final secretome product is separated from the living stem cells and passes through quality control before use.

A practical advantage of MSEC is that it can be stored after production. This allows ANOVA IRM to produce 10 injection doses from one liposuction and administer them over time.

This may be relevant for treatment planning in SCI cases where repeated applications are considered.

Learn more about our Secretome / Exosome therapies.

Diagram of adipose-derived mesenchymal stem cells releasing exosomes, growth factors, proteins, cytokines, miRNA, and microvesicles

MSC Secretome / Exosome Therapy

Bone Marrow Concentrate

Autologous Bone Marrow Concentrate (BMC) may be used for locally restricted damage in SCI, especially when one vertebra or a defined treatment region is involved.

In these cases, ANOVA IRM can treat the affected region with targeted, localized BMC injections. BMC contains autologous adult stem cells, including hematopoietic and mesenchymal stem cells in their natural composition, which are isolated and concentrated from the patient’s pelvic crest in a short procedure under light sedation.

BMC may be considered in selected cases where the treatment plan focuses on a defined local spinal or vertebral target.

For ongoing therapy, BMC may be combined with MSEC treatment.

Learn more about our Bone Marrow Concentrate therapies.

Diagram of Bone Marrow Concentrate showing adult stem cell types found in bone marrow and blood cell lineages

Bone Marrow Concentrate Therapy

HAL Exoskeleton Rehabilitation

Since 2019, ANOVA IRM has partnered with Cyberdyne Care Robotics to deliver functional training for spinal cord injury patients using the HAL® Hybrid Assistive Limb exoskeleton.

Cyberdyne’s state-of-the-art rehabilitation programs are used for intensive physiotherapy in incomplete or responsive SCI patients. To undergo HAL exoskeleton rehabilitation, patients must have measurable nerve signals during their first evaluation.

When these signals are present, HAL uses weak neurological impulses from the patient to help drive robotic movement and support neuro-functional feedback.

Training takes place at Cyberdyne’s German facility in Bochum. Patients typically train five days per week over the three-month program.

Learn more about HAL Exoskeleton Rehabilitation.

HAL exoskeleton used to support motor function and muscle strength during spinal cord injury rehabilitation

HAL Exoskeleton Training | © Cyberdyne

Combining Stem Cell Therapy With HAL Exoskeleton Training

At ANOVA IRM, stem cell-based therapies may be combined with Cyberdyne’s HAL Exoskeleton Rehabilitation through REMCell treatment.

This combination therapy is built on two principles:

  • The potential immune-modulating and anti-inflammatory mechanisms being studied in stem cell-based therapy
  • Neuro-functional training with the HAL exoskeleton using measurable residual neurological impulses

Stem cell therapy does not cure SCI. However, it may help improve the biological conditions needed for rehabilitation, especially when combined with intensive functional training.

HAL training takes place at Cyberdyne’s facility in Bochum. During the three-month REMCell program, patients return to Offenbach for continued stem cell-based treatment, with 10 MSEC doses typically administered every two weeks after production is complete.

REMCell should be understood as a possible pathway for selected patients, not as the standard treatment for every spinal cord injury case.

Learn more about our REMCell combination therapy.

Contraindications

Our stem cell treatments are experimental, but we only treat patients for whom we believe the risk/benefit ratio indicates treatment based on the state of the art, i.e., medical, scientific evidence.

Please understand that we therefore do not treat patients for whom the following points apply:

  • Active cancer in the last two years
  • Not yet of legal age
  • Existing pregnancy or lactation period
  • Unable to breathe on own, ventilator
  • Difficulty breathing in supine position
  • Dysphagia (extreme difficulty swallowing)
  • Psychiatric disorder
  • Active infectious disease (Hepatitis A, B, C, HIV, Syphilis, or other)

Who May Be a Candidate for SCI Stem Cell Therapy?

As an experimental treatment, stem cell-based therapy is not suitable for every spinal cord injury patient. Suitability depends on the type of injury, remaining neurological function, overall health, and rehabilitation potential. An individual medical review is required to determine whether treatment may be appropriate.

Patients who may be considered include those with:

  • Incomplete or partial spinal cord injuries
  • Cervical, thoracic, or lumbar spinal cord injuries
  • Spinal cord compression in selected cases
  • Spinal cord edema after surgery in selected cases
  • Chronic SCI with realistic expectations
  • Complete SCI only in selected responsive cases

Treatment may not be suitable for patients with:

  • No measurable residual nerve signaling, especially for REMCell/HAL treatment
  • Active cancer within the last two years
  • Active infectious disease
  • Pregnancy or lactation
  • Patients who are not legal adults
  • Severe breathing difficulty or ventilator dependence
  • Difficulty breathing while lying down
  • Severe dysphagia
  • Certain psychiatric disorders
  • Expectations of a guaranteed cure or full reversal of paralysis

For REMCell and HAL exoskeleton training, weak residual neurological impulses must be present and measurable. For MSEC / Secretome therapy, the patient must also be medically suitable for autologous MSEC production.

Therapy Workflow for REMCell Treatment of Spinal Cord Injury

What to Expect From the Treatment Process

Step 1: Remote Medical Record Review

 

Before treatment planning can begin, ANOVA IRM must first determine candidacy. To make this as easy as possible, prospective patients can start a remote case review before travelling to Germany.

Patients can begin the process by submitting the contact form. Shortly after, they receive an email with condition-specific information, including the experimental nature of the treatment and possible next steps. Interested patients can request more information. A patient care manager will then reach out to arrange a video consultation.

In some cases, ANOVA IRM may ask patients to send relevant imaging. However, this is not required for the initial consultation.

Patient care managers can help explain what information is needed upfront and schedule a call with an ANOVA physician to determine whether the patient should proceed with in-person eligibility testing and treatment planning.

Patient care team support is free. Physician appointment charges may apply, but the consultation fee is credited toward treatment costs if the patient proceeds.

 

Step 2: Pre-Treatment Eligibility Testing

 

Once initial suitability appears possible, patients will be directed to complete pre-treatment eligibility testing.

This typically starts with preliminary bloodwork in the patient’s home country to check for exclusion criteria such as HIV, hepatitis, syphilis, or other active infectious diseases. Patients with certain medical or substance-related risk factors may also be excluded.

If these preliminary results do not show exclusion criteria, patients may then travel to ANOVA IRM in Offenbach, Germany. On the first day of treatment at ANOVA IRM, the required testing is repeated according to German medical and regulatory requirements to confirm that the patient’s cells can be used in the laboratory.

 

Step 3: REMCell Treatment Planning

 

ANOVA IRM prepares a treatment plan in collaboration with Cyberdyne Care Robotics. This can often be arranged before travel to Germany is required for stem cell harvesting.

ANOVA IRM follows established application schedules for stem cell-based treatment in SCI patients, so treatment can be coordinated with ongoing HAL training. While this combined approach is generally recommended when HAL training is part of the treatment plan, the schedule may be adjusted based on the patient’s medical needs, availability, and individual treatment plan.

Before treatment begins, the expected timeline and cost estimate are clarified with the patient.

 

Step 4: Stem Cell Harvesting and Production

 

Stem cell harvesting is conducted approximately four weeks before treatment. At this stage, patients come to ANOVA IRM for the required tissue collection.

For REMCell treatment, this usually involves a mini-liposuction procedure to collect adipose tissue from abdominal fat. The mesenchymal stem cells are then isolated, cultivated, and used to produce the stem cell secretome.

The final secretome product no longer contains living MSCs. It then undergoes quality control before being stored for treatment.

If BMC is included in the patient’s treatment plan, bone marrow may also be harvested from the pelvic crest.

 

Step 5: REMCell Workflow With HAL Exoskeleton Training

 

Stem cell therapy is planned to coincide with HAL exoskeleton training at Cyberdyne’s facility in Bochum. Training typically takes place five days per week during the three-month program.

Patients return to ANOVA IRM in Offenbach according to their treatment plan, typically every two weeks, to receive new secretome doses. In total, 10 MSEC doses are usually administered over the three-month program.

This means REMCell patients should expect regular travel between Bochum and Offenbach during the treatment period.

 

Treatment Timeline and Travel Requirements

Initial analysis and counselling can usually begin remotely, without travelling to Offenbach. This stage may take two weeks to several months, depending on patient availability and scheduling.

The main treatment timeline is usually built around three stages:

  • Stem cell harvesting: Patients travel to ANOVA IRM in Offenbach for tissue collection. For MSEC / Secretome therapy, this usually involves approximately two consecutive days for adipose tissue harvesting and preparation.
  • Secretome production: After harvesting, the stem cell secretome is produced and quality-controlled. This process takes approximately four weeks.
  • REMCell treatment: REMCell includes a three-month HAL exoskeleton training program at Cyberdyne’s facility in Bochum. During this period, patients typically train five days per week and travel back to Offenbach for MSEC applications according to their treatment plan.

Because REMCell involves treatment in both Bochum and Offenbach, international patients should expect regular travel between the two locations during the treatment period. ANOVA IRM clarifies the expected timeline, number of visits, and travel requirements before treatment begins.

Cost of Stem Cell Therapy for Spinal Cord Injury

The cost of stem cell therapy for spinal cord injury depends on the patient’s condition, treatment plan, and whether HAL exoskeleton training is included.

When combined with HAL training, treatment may cost several tens of thousands of euros. Before treatment begins, ANOVA IRM provides an individual cost estimate so patients understand the expected cost of their treatment plan.

Does Health Insurance Cover the Therapy Costs?

Stem cell-based therapies for spinal cord injury are experimental and are generally not covered by health insurance.

Patients should expect to pay for treatment themselves unless their insurer confirms otherwise.

Why Choose ANOVA IRM for Spinal Cord Injury Treatment?

  • Autologous therapies: Treatment uses the patient’s own biological material, including MSEC / Secretome therapy and BMC, where appropriate.
  • REMCell combination treatment: Selected patients may combine stem cell-based therapy with HAL exoskeleton rehabilitation through Cyberdyne Care Robotics.
  • Controlled treatment in Germany: Treatment takes place at ANOVA IRM in Offenbach am Main, with HAL training coordinated in Bochum.
  • Individual medical review: Each patient is reviewed before treatment is recommended, with clear expectations around eligibility, timeline, cost, and experimental status.

How Does the ANOVA Therapy Differ? Precision Diagnostics for Individual Treatment Planning

Dr. mult. Michael K. Stehling, the founder of ANOVA IRM and the Vitus Prostate Center , is a radiologist (MD) and holds a PhD in physics. For this reason, the ANOVA Institute for Regenerative Medicine, in cooperation with the Prof. Stehling Institute for Diagnostic Imaging located in the same building, has the capability to use special precision diagnostics such as arthro-MRI and non-radioactive contrast MRIs.

Compared to many conventional MRIs, these methods are often able to localize the pain-causing inflammation, degeneration and damage in your spine and vertebrae. This enables us to determine individually how patients should be treated and where the stem cells should be applied.

Furthermore, in consultation with you and if necessary or advisable, we supplement our patient-specific diagnostics with specific blood tests on hormones, inflammation parameters and other factors that are important in your case, or recommend further examinations such as a preventive MRI spinal scan.

Precision MRI diagnostics for spinal and pain assessment at ANOVA IRM

Precision MRI scans - find the source of pain
ANOVA IRM © Siemens Healthcare GmbH

How Does the ANOVA Therapy Differ? Targeted, Image-Guided Treatment

Based on our specific diagnostics using arthro-MRI and non-radioactive contrast medium MRIs, we can, in contrast to many other clinics, deliver the stem cells with image support, e.g. using CT, precisely to the affected area. This means we can inject into and at joints, vertebrae and ligaments to specifically and quickly trigger an effect where inflammation causes pain. All interventions are performed under supervision and care of our anesthesiologist and are pain free.

Of course, we will thoroughly advise you in the early process and the on-site consultation in advance on all steps and discuss alternatives and expectations.

© Learn More

CT-assisted stem cell injection into joints | ANOVA

CT-assisted stem cell injection into joints
ANOVA IRM © Siemens Healthcare GmbH

How HAL Neuro-Functional Training Works

This generates nerve signals in so-called proprioceptors in the muscles and joints, which are fed back to the brain (afferent signals). These afferent signals originating in the legs and going to the brain, and efferent signals, running down the spinal cord to the peripheral nerves form a feedback loop. In patients with SCI this feedback loop is interrupted and with time degenerates.

Functional MRI studies, which can visualize brain activity, have shown that the areas in the motor cortex of the brain (gyrus praecentralis), which control specific movements of the legs and are normally very focused on small areas of the motor cortex, "smear out" over larger areas in patients with SCI. This might impede voluntary initiation of motion by deeper functional centers of the brain.

During HAL training, the functional activity is refocused onto the original smaller areas. It thus appears that the re-establishment of the feedback loop, particularly the sensory input from the proprioceptors in the leg to the brain, is an essential component of voluntary motion.

Request a Medical Evaluation

Find out whether stem cell-based therapy may be suitable for your spinal cord injury.

ANOVA IRM can begin with a remote medical review before you travel to Germany. Our patient care team can explain the next steps and help arrange a physician consultation with Dr. Michael K. Stehling.

Because stem cell-based therapy for SCI is experimental, treatment can only be recommended after an individual medical review and benefit-risk assessment. ANOVA IRM cannot treat children or pregnant patients, and other medical factors may also exclude a patient from treatment.

Contact us to begin your remote medical evaluation.

Frequently Asked Questions About Stem Cell Therapy for Spinal Cord Injury

Is stem cell therapy for spinal cord injury available at ANOVA IRM?

Yes. ANOVA IRM offers stem cell-based therapy for selected spinal cord injury patients after medical review. Treatment may involve MSEC / Secretome therapy, Bone Marrow Concentrate, HAL exoskeleton rehabilitation, or a combination, depending on suitability.

Can stem cell therapy cure spinal cord injury?

No. Stem cell therapy is not an established cure for spinal cord injury, and treatment cannot guarantee restored walking ability, motor function, or full neurological recovery. At ANOVA IRM, stem cell-based therapy is considered experimental and can only be recommended after individual medical review.

Who is a candidate for SCI stem cell therapy?

Suitability depends on the type of injury, remaining neurological function, overall health, and rehabilitation potential. Patients with incomplete or partial spinal cord injuries may be more likely to be considered, while complete SCI is only considered in selected responsive cases.

What is MSEC / Stem Cell Secretome therapy?

MSEC stands for Mesenchymal Stem Cell Secretome. It is a cell-free therapy that uses the bioactive molecules released by mesenchymal stem cells, including exosomes and other signalling substances, rather than transplanting living stem cells directly.

What is REMCell therapy?

REMCell stands for Robotic Exoskeleton and Mesenchymal Stem Cell Therapy. It combines stem cell-based regenerative treatment at ANOVA IRM with HAL exoskeleton rehabilitation through Cyberdyne Care Robotics for selected patients with measurable residual nerve signals.

How long does treatment take?

The timeline depends on the treatment protocol. Initial review can begin remotely, while tissue harvesting and pre-treatment testing require travel to Offenbach. MSEC production takes approximately four weeks, and REMCell treatment with HAL training may involve a three-month program in Bochum with regular visits to Offenbach.

How much does stem cell therapy for spinal cord injury cost?

Costs depend on the patient’s condition, treatment plan, and whether HAL exoskeleton training is included. When combined with HAL training, treatment may cost several tens of thousands of euros. ANOVA IRM provides an individual cost estimate before treatment begins.

Does health insurance cover stem cell therapy for spinal cord injury?

Stem cell-based therapies for spinal cord injury are experimental and are generally not covered by health insurance. Patients should expect to pay for treatment themselves unless their insurer confirms otherwise.

Can international patients apply for treatment?

Yes. International patients can begin with a remote review before travelling to Germany. ANOVA IRM’s patient care team can explain what information is needed and help arrange the next steps for physician consultation, pre-treatment testing, and treatment planning.

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Christopher and Dana Reeve Foundation

Stem cell clinical trial aims to combat nerve damage in human tissue

Stem Cell Secretome for Spinal Cord Repair: Is It More than Just a Random Baseline Set of Factors?

References and Literature: Stem Cell-Based Therapies and Spinal Cord Injury

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  2. Anthony DF, Shiels PG. Exploiting paracrine mechanisms of tissue regeneration to repair damaged organs. Transplantation Research. 2013;2(1):10.
  3. Wright KT, Masri WE, Osman A, Chowdhury J, Johnson WEB. Concise review: Bone marrow for the treatment of spinal cord injury: mechanisms and clinical implications. Stem Cells. 2011;29:169–178.
  4. Quertainmont R, Cantinieaux D, Botman O, Eid S, Schoenen J, Franzen R. Mesenchymal stem cell graft improves recovery after spinal cord injury in adult rats through neurotrophic and pro-angiogenic actions. PLOS ONE. 2012;7.
  5. Lamichhane TN, et al. Emerging roles for extracellular vesicles in tissue engineering and regenerative medicine. Tissue Engineering Part B: Reviews. 2014;21(1):45–54.
  6. Thuret S, Moon LDF, Gage FH. Therapeutic interventions after spinal cord injury. Nature Reviews Neuroscience. 2006;7(8):628–643.
  7. Lindvall O, Kokaia Z. Stem cells for the treatment of neurological disorders. Nature. 2006;441(7097):1094–1096.
  8. Yoon SH, Shim YS, Park YH, Chung JK, Nam JH, Kim MO, Park HC, Park SR, Min BH, Kim EY, et al. Complete spinal cord injury treatment using autologous bone marrow cell transplantation and bone marrow stimulation with granulocyte macrophage-colony stimulating factor: Phase I/II clinical trial. Stem Cells. 2007;25(8):2066–2073.
  9. Karamouzian S, Nematollahi-Mahani SN, Nakhaee N, et al. Clinical safety and primary efficacy of bone marrow mesenchymal cell transplantation in subacute spinal cord injured patients. Clinical Neurology and Neurosurgery. 2012;114(7):935–939.
  10. Saito F, Nakatani T, Iwase M, et al. Spinal cord injury treatment with intrathecal autologous bone marrow stromal cell transplantation: the first clinical trial case report. Journal of Trauma. 2008;64(1):53–59.
  11. Saito F, Nakatani T, Iwase M, et al. Administration of cultured autologous bone marrow stromal cells into cerebrospinal fluid in spinal injury patients: a pilot study. Restorative Neurology and Neuroscience. 2012;30(2):127–136.

Further References About MSEC and Stem Cell Therapies for Spinal Cord Injuries

  1. Ramer LM, Ramer MS, Bradbury EJ. Restoring function after spinal cord injury: Towards clinical translation of experimental strategies. The Lancet Neurology. 2014;13:1241–1256. https://doi.org/10.1016/S1474-4422(14)70144-9
  2. Silva NA, Sousa N, Reis RL, Salgado AJ. From basics to clinical: A comprehensive review on spinal cord injury. Progress in Neurobiology. 2014;114:25–57. https://doi.org/10.1016/j.pneurobio.2013.11.002
  3. Bradbury EJ, Burnside ER. Moving beyond the glial scar for spinal cord repair. Nature Communications. 2019;10:3879. https://doi.org/10.1038/s41467-019-11707-7
  4. Schuld C, Franz S, Bruggemann K, Heutehaus L, Weidner N, Kirshblum SC, Rupp R, EMSCI Study Group. International standards for neurological classification of spinal cord injury: Impact of the revised worksheet (revision 02/13) on classification performance. Journal of Spinal Cord Medicine. 2016;39:504–512. https://doi.org/10.1080/10790268.2016.1180831
  5. Anderson DK, Means ED, Waters TR, Green ES. Microvascular perfusion and metabolism in injured spinal cord after methylprednisolone treatment. Journal of Neurosurgery. 1982;56:106–113. https://doi.org/10.3171/jns.1982.56.1.0106
  6. Oyinbo CA. Secondary injury mechanisms in traumatic spinal cord injury: A nugget of this multiply cascade. Acta Neurobiologiae Experimentalis. 2011;71:281–299.
  7. Kakulas BA. Neuropathology: The foundation for new treatments in spinal cord injury. Spinal Cord. 2004;42:549–563. https://doi.org/10.1038/sj.sc.3101670
  8. Rowland JW, Hawryluk GW, Kwon B, Fehlings MG. Current status of acute spinal cord injury pathophysiology and emerging therapies: Promise on the horizon. Neurosurgical Focus. 2008;25. https://doi.org/10.3171/FOC.2008.25.11.E2
  9. Donnelly DJ, Popovich PG. Inflammation and its role in neuroprotection, axonal regeneration and functional recovery after spinal cord injury. Experimental Neurology. 2008;209:378–388. https://doi.org/10.1016/j.expneurol.2007.06.009
  10. Pires AO, Mendes-Pinheiro B, Teixeira FG, Anjo SI, Ribeiro-Samy S, Gomes ED, Serra SC, Silva NA, Manadas B, Sousa N, et al. Unveiling the differences of secretome of human bone marrow mesenchymal stem cells, adipose tissue-derived stem cells, and human umbilical cord perivascular cells: A proteomic analysis. Stem Cells and Development. 2016;25:1073–1083. https://doi.org/10.1089/scd.2016.0048
  11. Nagoshi N, Nakashima H, Fehlings MG. Riluzole as a neuroprotective drug for spinal cord injury: From bench to bedside. Molecules. 2015;20:7775–7789. https://doi.org/10.3390/molecules20057775
  12. Salewski RP, Mitchell RA, Li L, Shen C, Milekovskaia M, Nagy A, Fehlings MG. Transplantation of induced pluripotent stem cell-derived neural stem cells mediate functional recovery following thoracic spinal cord injury through remyelination of axons. Stem Cells Translational Medicine. 2015;4:743–754. https://doi.org/10.5966/sctm.2014-0236
  13. Zakrzewski W, Dobrzynski M, Szymonowicz M, Rybak Z. Stem cells: Past, present, and future. Stem Cell Research & Therapy. 2019;10:68. https://doi.org/10.1186/s13287-019-1165-5
  14. Chen CJ, Ou YC, Liao SL, Chen WY, Chen SY, Wu CW, Wang CC, Wang WY, Huang YS, Hsu SH. Transplantation of bone marrow stromal cells for peripheral nerve repair. Experimental Neurology. 2007;204:443–453. https://doi.org/10.1016/j.expneurol.2006.12.004

Literature on HAL Training and Spinal Cord Injury Rehabilitation

  1. Grasmücke D, Zieriacks A, Jansen O, Fisahn C, Sczesny-Kaiser M, Wessling M, Meindl RC, Schildhauer TA, Aach M. Against the odds: what to expect in rehabilitation of chronic spinal cord injury with a neurologically controlled Hybrid Assistive Limb exoskeleton. A subgroup analysis of 55 patients according to age and lesion level. Neurosurgical Focus. 2017;42(5). https://doi.org/10.3171/2017.2.FOCUS171
  2. Brinkemper A, Grasmücke D, Yilmaz E, Reinecke F, Schildhauer TA, Aach M. Influence of locomotion therapy with the wearable cyborg HAL on bladder and bowel function in acute and chronic SCI patients. Global Spine Journal. 2021. https://doi.org/10.1177/21925682211003851
  3. Jansen O, Schildhauer TA, Meindl RC, Tegenthoff M, Schwenkreis T, Sczesny-Kaiser M, Grasmücke D, Fisahn C, Aach M. Functional outcome of neurologic-controlled HAL-exoskeletal neurorehabilitation in chronic spinal cord injury: A pilot with one year treatment and variable treatment frequency. Global Spine Journal. 2017. https://doi.org/10.1177/2192568217713754
  4. Jansen O, Grasmücke D, Meindl RC, Tegenthoff M, Schwenkreis P, Sczesny-Kaiser M, Wessling M, Schildhauer TA, Fisahn C, Aach M. Hybrid Assistive Limb exoskeleton HAL in the rehabilitation of chronic spinal cord injury: Proof of concept; the results in 21 patients. World Neurosurgery. 2018. https://doi.org/10.1016/j.wneu.2017.10.080
  5. Sczesny-Kaiser M, Höffken O, Aach M, Cruciger O, Grasmücke D, Meindl R, Schildhauer TA, Schwenkreis P, Tegenthoff M. HAL® exoskeleton training improves walking parameters and normalizes cortical excitability in primary somatosensory cortex in spinal cord injury patients. Journal of NeuroEngineering and Rehabilitation. 2015. https://doi.org/10.1186/s12984-015-0058-9
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  1. Xu, Ming, et al. " Transplanted senescent cells induce an osteoarthritis-like condition in mice. " The Journals of Gerontology Series A: Biological Sciences and Medical Sciences (2016): glw154.
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Contraindications

Our stem cell treatments are experimental, but we only treat patients for whom we believe the risk/benefit ratio indicates treatment based on the state of the art, i.e., medical, scientific evidence.

Please understand that we therefore do not treat patients for whom the following points apply:

  • Active cancer in the last two years
  • Not yet of legal age
  • Existing pregnancy or lactation period
  • Unable to breathe on own, ventilator
  • Difficulty breathing in supine position
  • Dysphagia (extreme difficulty swallowing)
  • Psychiatric disorder
  • Active infectious disease (Hepatitis A, B, C, HIV, Syphilis, or other)