Autologous, micro-fragmented adipose tissue as a treatment for chronic shoulder pain in a wheelchair using individual with spinal cord injury: a case report

Spinal Cord Series and Cases, 2019 · DOI: 10.1038/s41394-019-0186-8 · Published: April 18, 2019

Spinal Cord Injury Regenerative Medicine Orthopedics

Simple Explanation

This case report discusses a novel treatment for chronic shoulder pain in a wheelchair user with a spinal cord injury (SCI). Shoulder pain is a common issue among individuals with SCI, often stemming from overuse of the upper limbs. The treatment involves injecting autologous, micro-fragmented adipose tissue (MFAT) into the affected shoulder area under ultrasound guidance. MFAT is derived from the patient's own fat tissue and is believed to have regenerative and anti-inflammatory properties. The study showed that the patient experienced significant improvements in pain and shoulder function, which were sustained for at least one year following the MFAT injection. This suggests that MFAT injection could be a promising alternative treatment option for chronic shoulder pain in SCI patients.

Study Duration

1 year

Participants

A 54-year-old male with T10 complete SCI

Evidence Level

Level 4: Case Report

Key Findings

1
The patient experienced complete relief from pain, which was maintained at the 1-year follow-up after receiving the MFAT injection.
2
MRI scans revealed a 50 percent improvement in the partial articular surface insertional tear of the anterior infraspinatus and posterior supraspinatus tendons after 12 months.
3
The patient's Wheelchair User’s Shoulder Pain Index (WUSPI) score improved to 0 at the 12-month follow-up, indicating a significant improvement in shoulder pain and function.

Research Summary

This case report presents the successful treatment of chronic refractory shoulder pain in a 54-year-old male with a T10 complete SCI using ultrasound-guided injection of autologous MFAT. The patient, who had been experiencing right shoulder pain for 3 years and had not responded to conservative treatments, demonstrated significant improvements in pain, function, and MRI findings after the MFAT injection. The findings suggest that MFAT injection could be a potential therapeutic option for addressing chronic shoulder pain in the SCI population, warranting further research.

Practical Implications

Alternative Treatment Option

MFAT injection offers a potential alternative to surgery for individuals with SCI experiencing chronic shoulder pain that is unresponsive to conservative treatments.

Improved Quality of Life

The reduction in pain and improvement in shoulder function can lead to a better quality of life and increased functional independence for wheelchair users with SCI.

Further Research Needed

Additional studies are needed to validate the effectiveness of MFAT injection, compare it to other therapies, and determine the optimal treatment protocols for this patient population.

Study Limitations

1
Potential placebo effect may have contributed to the subjective improvements reported by the patient.
2
The degree of tendinosis seen in the supraspinatus, infraspinatus, and subscapularis remained unchanged at 12 months.
3
The MFAT injection was accompanied by needling of the tendon and a formal stretching and strengthening program, making it difficult to isolate the specific effect of MFAT.

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