The authors report the case of a 40-year-old man who suffered paraplegia from 2013, due to shot by firearm. In april 2017 he underwent cell therapy consisting of administration of autologous bone marrow stromal cells (BMSCs) into injured spinal cord and subarachnoid space by lumbar puncture. Throughout one year of follow-up, the patient experienced clear improvement in sensitivity, motor, and sphincter functions. After BMSCs administration, studies with 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) suggested an enhancement in glucose uptake at level of injured spinal cord, at least in the course or the first 6 months after the start of cell therapy. This case supports previous observations about the improvements obtained by cell therapy with autologous BMSCs in chronic paraplegic patients, and suggests that a possible increase in tissue metabolism, mediated by the presence of BMSCs into injured spinal cord, can be one of the causes of early clinical improvements.