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remote."},"requirement":"routine"},{"purpose":"result_review","after":{"min":180,"max":365,"unit":"days","qualifier":"Functional outcome review with GMFCS and motor scales."},"requirement":"routine"}],"indications":["Spastic cerebral palsy with motor impairment","Dyskinetic or ataxic cerebral palsy","Cerebral palsy with persistent functional limitation despite standard rehabilitation"],"main_risks":["Infusion or injection reactions, fever, infection or contamination risk.","Immune reactions to donor (allogeneic) cells.","Post-lumbar puncture headache with intrathecal delivery.","Bone marrow harvest pain or bleeding with autologous cells."],"pain":"Mild to moderate discomfort at the cell harvest, injection or lumbar puncture site. Headache or low-grade fever may occur for a few days.","preparation":["Share brain MRI and neurology reports","Blood tests and infection screening","Review anti-epileptic and anticoagulant medication","Fast before sedation as instructed","Avoid recent infections or vaccinations","Plan rehabilitation continuity at home"],"recovery_timeline":[{"phase":"Day of administration","description":"Cells delivered intravenously, intrathecally or by another route, then observed for reactions.","restrictions":["Rest and avoid strenuous activity"]},{"phase":"Days 1-7","description":"Monitoring for fever, headache, and site discomfort while rehabilitation therapy begins gently.","restrictions":["No heavy exertion","Keep lying flat if advised after lumbar puncture"]},{"phase":"Weeks 2-4","description":"Intensive rehabilitation continues, with return to usual routine.","restrictions":["Avoid new infections exposure where possible"]},{"phase":"Months 3-12","description":"Gradual assessment of motor and functional changes with ongoing therapy.","restrictions":[]}],"rehabilitation_days":{"min":7,"max":14,"unit":"days","qualifier":"Intensive physiotherapy paired with administration; length depends on severity and programme."},"result_longevity":"Durability of any benefit is not established. Some clinics repeat courses at 3-6 month intervals.","revision_rate_pct":null,"scars":"No visible scars; only small needle puncture marks, plus a tiny bone marrow harvest site if used.","sessions_or_stages":{"sessions":{"min":1,"max":3,"unit":"visits","qualifier":"Often a single course; some programmes repeat administration at 3-6 month intervals."},"stages":[{"code":"assessment_and_screening","label":"Medical review and screening","after":{"min":0,"max":0,"unit":"days","qualifier":"Before administration"}},{"code":"cell_administration","label":"Stem cell administration","after":{"min":1,"max":7,"unit":"days","qualifier":"May be repeated over several days depending on protocol"}},{"code":"rehabilitation","label":"Rehabilitation programme","after":{"min":2,"max":14,"unit":"days","qualifier":"Alongside and after administration"}}],"qualifier":"Typical protocol is one course of cell administration with rehabilitation."},"success":{"metric":null,"value":null,"unit":null,"horizon":null,"population":"Children and adults with cerebral palsy receiving stem cell therapy alongside rehabilitation","evidence_status":"not_proven"},"techniques":[{"name":"Intravenous infusion of mesenchymal stem cells","suits_whom":"Patients preferring a least invasive route.","recovery":"Observation for hours; minimal downtime."},{"name":"Intrathecal injection via lumbar puncture","suits_whom":"Patients where central nervous system delivery is intended.","recovery":"Lie flat for hours; headache possible for days."},{"name":"Autologous bone marrow mononuclear cells","suits_whom":"Patients using own cells, avoiding donor immune reactions.","recovery":"Bone marrow harvest soreness for a few days."},{"name":"Umbilical cord blood cell infusion","suits_whom":"Patients using donor or banked cord blood cells.","recovery":"Observation for infusion reactions; minimal downtime."}],"treatment_conditions":["day_case","inpatient"],"treatment_duration_hours":{"min":1,"max":4,"unit":"hours","qualifier":"Per administration session, including sedation and observation; bone marrow harvest adds time."},"initial_assessment_documents":["Brain MRI report and images","Neurologist report with CP diagnosis and GMFCS level","Recent video of motor function","Seizure history and anti-epileptic medication list","Recent blood test results","Previous treatment and rehabilitation summary"],"travel_trips":{"min":1,"max":3,"one_trip_possible":true,"qualifier":"Often one 1-2 week trip with cell administration and rehab; some clinics repeat courses at 3-6 month intervals."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Confirm the surgeon is trained and experienced in the exact procedure you are considering, not just in surgery 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