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Technical note: accuracy and precision in stereotactic stem cell transplantation

  • Technical Note - Functional Neurosurgery - Other
  • Published:
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Abstract

Background

While multiple trials have employed stereotactic stem cell transplantation, injection techniques have received little critical attention. Precise cell delivery is critical for certain applications, particularly when targeting deep nuclei.

Methods

Ten patients with a history of ischemic stroke underwent CT-guided stem cell transplantation. Cells were delivered along 3 tracts adjacent to the infarcted area. Intraoperative air deposits and postoperative T2-weighted MRI fluid signals were mapped in relation to calculated targets.

Results

The deepest air deposit was found 4.5 ± 1.0 mm (mean ± 2 SEM) from target. The apex of the T2-hyperintense tract was found 2.8 ± 0.8 mm from target. On average, air pockets were found anterior (1.2 ± 1.1 mm, p = 0.04) and superior (2.4 ± 1.0 mm, p < 0.001) to the target; no directional bias was noted for the apex of the T2-hyperintense tract. Location and distribution of air deposits were variable and were affected by the relationship of cannula trajectory to stroke cavity.

Conclusions

Precise stereotactic cell transplantation is a little-studied technical challenge. Reflux of cell suspension and air, and the structure of the injection tract affect delivery of cell suspensions. Intraoperative CT allows assessment of delivery and potential trajectory correction.

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Funding

No funding was received for this research.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Chicago, 5841 S. Maryland Avenue, MC 3026, Chicago, IL, 60637, USA

    David Satzer & Peter C. Warnke

Authors
  1. David Satzer
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  2. Peter C. Warnke
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Corresponding author

Correspondence to David Satzer.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Chicago Institutional Review Board (IRB#15-1409) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Comments

This is very interesting study evaluating a technique for precise stereotactic stem cell transplantation in humans after ischemic stroke. The study is well-written with appropriate methodology and meaningful conclusions. This study adds to the important and growing body of work regarding stem cell therapy in humans after neurological injury. The authors are congratulated for their efforts, and I look forward to further work from them in this important area.

Ali S. Haider

Illinois, USA

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This article is part of the Topical Collection on Functional Neurosurgery - Other

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Satzer, D., Warnke, P.C. Technical note: accuracy and precision in stereotactic stem cell transplantation. Acta Neurochir 161, 2059–2064 (2019). https://doi.org/10.1007/s00701-019-03964-8

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  • DOI: https://doi.org/10.1007/s00701-019-03964-8

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