Degenerative disc disease, which is often accompanied by chronic low back pain, may occur through different mechanisms, including injury and genetics. Regardless of the root cause, all cases of degenerative disc disease involve an environment in which intervertebral discs are degraded.
Nonsurgical approaches, such as limiting motion in the lumbar spine, are often recommended for patients suffering from this disorder, as are surgical procedures including lumbar fusion and lumbar disc arthroplasty, also known as total disc replacement. Unfortunately, most treatment options focus on relieving the symptoms of degenerative disc disease rather than on correcting the underlying problem and are therefore not largely effective in the long-term.
Regenerative medicine has offered new treatments across a number of orthopedic conditions and may provide promise for those suffering from degenerative disc disease. One recent study, published in Stem Cells, investigated the effect of bone marrow concentrate cells on lumbar pain associated with degenerative disc disease.
After obtaining baseline pain scores through tests known as the Pretreatment Oswestery Disability Index and the Visual Analog Scale and images of the spineusing magnetic resonance imaging (MRI), scientists injected the discs of 26 patients, ranging in age from 18 to 61, with bone marrow concentrate cells. Patients’ pain as well as the condition of their spine were evaluated again at 3 months, 6 months, and 12 months following the treatment.
The patients experienced pain reduction, and those who received larger volume injections had more substantial and faster reductions in pain. At one-year post-treatment, almost 60% of patients had pain relief. Additionally, almost half of the patients showed disc morphology improvements as evaluated via MRI.
In addition to being effective in pain reduction in patients with degenerative disc disease, bone marrow concentrate cell therapy was not associated with adverse side effects and so appears to be a safe option for this set of patients. Given that conventional therapies are not fully effective, and invasive procedures like lumbar fusion remain controversial, more research into the potential use of cell-based therapies for patients with degenerative disc disease is likely to be pursued and lead to more options for these patients.
References
Abi-Hanna, D., Kerferd, J., Phan, K., Rao, P., & Mobbs, R. (2018). Lumbar Disk Arthroplasty for Degenerative Disk Disease: Literature Review. World Neurosurgery, 109, 188–196. https://doi.org/10.1016/j.wneu.2017.09.153
Dowdell, J., Erwin, M., Choma, T., Vaccaro, A., Iatridis, J., & Cho, S. K. (2017). Intervertebral Disk Degeneration and Repair. Neurosurgery, 80(3S), S46–S54. https://doi.org/10.1093/neuros/nyw078
Pettine, K. A., Murphy, M. B., Suzuki, R. K., & Sand, T. T. (2015). Percutaneous injection of autologous bone marrow concentrate cells significantly reduces lumbar discogenic pain through 12 months. Stem Cells (Dayton, Ohio), 33(1), 146–156. https://doi.org/10.1002/stem.1845
Taher, F., Essig, D., Lebl, D. R., Hughes, A. P., Sama, A. A., Cammisa, F. P., & Girardi, F. P. (2012). Lumbar degenerative disc disease: current and future concepts of diagnosis and management. Advances in Orthopedics, 2012, 970752. https://doi.org/10.1155/2012/970752
Tibiletti, M., Kregar Velikonja, N., Urban, J. P. G., & Fairbank, J. C. T. (2014). Disc cell therapies: critical issues. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 23 Suppl 3, S375-84. https://doi.org/10.1007/s00586-014-3177-2
Vedicherla, S., & Buckley, C. T. (2017). Cell-based therapies for intervertebral disc and cartilage regeneration- Current concepts, parallels, and perspectives. Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society, 35(1), 8–22. https://doi.org/10.1002/jor.23268
