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Study design:Case report.Objective:Report rapid neurological changes in a complete tetraplegic following a cell injection procedure.Setting:Beijing, China.Methods:ASIA/IMSOP neurological scale. Immunostaining of cell cultures. Cellular transplantation to effect functional restoration following spinal cord injury (SCI) has been hypothesized to cause improvements through axonal regeneration, increased plasticity, or axonal remyelination. Several human trials are in preliminary phases. We report a rapid improvement in motor and sensory functions in the segment adjacent to the level of complete SCI within days following cellular transplantation of cultured fetal olfactory bulb-derived cells. The patient was an 18-year-old C3 ASIA A complete tetraplegic 18 months post-injury who had been neurologically stable for more than 6 months.Results:Within 48 h of cell transplantation, the patient improved one ASIA motor grade in the left elbow flexors and began to show right wrist extensor function. Descent of the sensory level occurred within 4 days and then the rate of change slowed. He is now a C5 motor and C4 sensory complete tetraplegic. Cellular cultures prepared in the same facility showed viable human cells that labeled for nestin and GFAP.Conclusion:We hypothesize that improved transmission in intact fibers subserving the zone of partial preservation accounts for these early improvements. We emphasize the need for further independent analysis of the outcomes of this and other preliminary cell transplant studies.Spinal Cord (2006) 44, 135–142. doi:10.1038/sj.sc.3101820; published online 6 September 2005 [ABSTRACT FROM AUTHOR]