Cell therapy for intervertebral disc herniation and degenerative disc disease: clinical trials

Low back pain and degenerative disc disease are a significant cause of pain and disability worldwide. Advances in regenerative medicine and cell-based therapies, particularly the transplantation of mesenchymal stem cells and intervertebral disc chondrocytes, have led to the publication of numerous studies and clinical trials utilising these biological therapies to treat degenerative spinal conditions, often reporting favourable outcomes. Stem cell mediated disc regeneration may bridge the gap between the two current alternatives for patients with low back pain, often inadequate pain management at one end and invasive surgery at the other. Through cartilage formation and disc regeneration or via modification of pain pathways stem cells are well suited to enhance spinal surgery practice. This paper will systematically review the current status of basic science studies, preclinical and clinical trials utilising cell-based therapies to repair the degenerate intervertebral disc. The mechanism of action of transplanted cells, as well as the limitations of published studies, will be discussed.

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Pulmonary Impairment Rating

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2016.julaug03 ◽

2016 ◽

Vol 21 (4) ◽

pp. 8-11

Author(s):

Jay Blaisdell ◽

James B. Talmage ◽

Stephen Demeter

Keyword(s):

Intervertebral Disc ◽

Degenerative Disc Disease ◽

Spinal Pain ◽

Clinical Syndrome ◽

Intervertebral Disc Herniation ◽

Disc Disease ◽

Degenerative Disc ◽

Motion Segment ◽

Objective Evidence ◽

Disc Herniations

Abstract Nonspecific spinal pain and intervertebral disc herniations are common, and in evaluating spinal impairment physicians should carefully assess the significance of imaging findings, physical examination findings, and reports of limb pain. A case example illustrates key principles in assessing cervical pain in an individual with questionable arm complaints. A 62-year-old man had a slip and fall injury. Imaging studies revealed degenerative disc disease with disc bulges and without specific disc herniations according to the radiologists, but his physician reviewed magnetic resonance imaging (MRI) films and reported multiple disc herniations. The case example illustrates the significance of the finding of degenerative disc disease, determining whether to rate for “soft tissue and nonspecific conditions” or “motion segment lesions,” and assessing “nonverifiable radicular complaints.” The authors note that cervical degenerative disc “disease” is more aptly a radiologic diagnosis reflecting aging rather than a clinical syndrome and does not necessarily imply that the degenerative disc disease is the cause of the pain. To distinguish between nonverifiable radicular complaints without objective evidence of radiculopathy and unreliable vague complaints involving the extremity, evaluators should determine that the complaints are consistently and repetitively recognized in medical records and that they lie in the distribution of a single nerve root that the examiner can name. The diagnosis of “intervertebral disc herniation” cannot be made, and instead the “nonspecific chronic pain” diagnosis can be used. Nor can the diagnosis of alteration of motion segment integrity be used because the case lacks radiographically documented instability.

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A Combinational Approach Using Cell Therapy, Tissue Engineering, and Distracting Device for the Treatment of Degenerative Disc Disease

Stem Cells Research Development & Therapy ◽

10.24966/srdt-2060/100064 ◽

2021 ◽

Vol 7 (1) ◽

pp. 1-5

Author(s):

G Rasul Chaudhry ◽

Keyword(s):

Tissue Engineering ◽

Cell Therapy ◽

Intervertebral Disc ◽

Degenerative Disc Disease ◽

Organization Structure ◽

Structure And Function ◽

Disc Disease ◽

Degenerative Disc ◽

Vertebral Bodies ◽

And Function

The Intervertebral Disc (IVD) is a fibrocartilaginous tissue instrumental in spine flexibility, allowing for the bending and twisting motion between vertebral bodies. Degenerative Disc Disease (DDD) results from the complex and chronic deterioration in IVD organization, structure, and function

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Regeneration Potential of Stem Cell in the Treatment of IVD

International Journal for Research in Applied Science and Engineering Technology ◽

10.22214/ijraset.2021.37908 ◽

2021 ◽

Vol 9 (8) ◽

pp. 3022-3036

Author(s):

Riya Bhanushali

Keyword(s):

Stem Cells ◽

Mesenchymal Stem Cells ◽

Stem Cell ◽

Cell Therapy ◽

Intervertebral Disc ◽

Stem Cell Therapy ◽

Degenerative Disc Disease ◽

Disc Disease ◽

Degenerative Disc ◽

Potential Use

Abstract: Degenerative disc disease is a prevalent musculoskeletal disorder in which damaged spinal discs cause pain upon aging, accidental injuries. Spinal discs connect adjacent vertebrae and help in maintaining mobility, flexibility and rotation of spinal cord. Spinal discs also act as shock absorbers. Intervertebral disc (IVD) degeneration is often associated with low back and neck pain, which accounts for disability worldwide. Physical therapy, spinal fusion surgeries reduce severity and symptoms of degenerative disc disease but they are not complete cure for this disease. Current preclinical studies show that mesenchymal stem cells have the capacity to repair degenerative disks by differentiation to chondrocyte-like cells, which produce proteoglycans and type II collagen. Mesenchymal stem cells (MSCs) isolated from bone marrow (BM-MSCs), adipose tissue (AD-MSCs) and umbilical cord (UC-MSCs) show potential use in cartilage and intervertebral disc (IVD) repair. Regenerative medicine and stem cell therapy hold great promise for treatment of intervertebral disc (IVD) disease. This review discusses about progression of degenerative disc disease, various types of stem cells, potential use of mesenchymal stem cells (MSCs) and embryonic stem cells (ESCs) for the treatment of degenerative disc disease. This review also focuses upon challenges encountered by the application of stem cell therapy for treating degenerative disc disease as well as future perspectives. Keywords: IVD, Stem cell therapy, AF & NP cells, MSCs, Scaffolds, Cell therapy

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Chemometric evaluation of concentrations of trace elements in intervertebral disc tissue in patient with degenerative disc disease

Annals of Agricultural and Environmental Medicine ◽

10.5604/12321966.1232555 ◽

2017 ◽

Vol 24 (4) ◽

pp. 610-617

Author(s):

Łukasz Kubaszewski ◽

Anetta Zioła-Frankowska ◽

Zuzanna Gasik ◽

Marcin Frankowski ◽

Mikołaj Dąbrowski ◽

...

Keyword(s):

Trace Elements ◽

Intervertebral Disc ◽

Degenerative Disc Disease ◽

Disc Disease ◽

Degenerative Disc ◽

Disc Tissue

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Characterization of neuroinflammation and periphery-to-CNS inflammatory cross-talk in patients with disc herniation and degenerative disc disease

Brain Behavior and Immunity ◽

10.1016/j.bbi.2018.09.010 ◽

2019 ◽

Vol 75 ◽

pp. 60-71 ◽

Cited By ~ 14

Author(s):

Vinko Palada ◽

Aisha Siddiqah Ahmed ◽

Anja Finn ◽

Svante Berg ◽

Camilla I. Svensson ◽

...

Keyword(s):

Disc Herniation ◽

Cross Talk ◽

Degenerative Disc Disease ◽

Disc Disease ◽

Degenerative Disc

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HISTOLOGICAL MARKERS OF DEGENERATION AND REGENERATION OF THE HUMAN INTERVERTEBRAL DISK

Coluna/Columna ◽

10.1590/s1808-185120171601170833 ◽

2017 ◽

Vol 16 (1) ◽

pp. 42-47

Author(s):

MANUELA PELETTI-FIGUEIRÓ ◽

ISRAEL SILVEIRA DE AGUIAR ◽

SUELEN PAESI ◽

DENISE CANTARELLI MACHADO ◽

SERGIO ECHEVERRIGARAY ◽

...

Keyword(s):

Cell Proliferation ◽

Intervertebral Disc ◽

Disc Degeneration ◽

Degenerative Disc Disease ◽

Intervertebral Disc Degeneration ◽

Disc Disease ◽

Lumbar Degenerative Disc Disease ◽

Degenerative Disc ◽

Hematoxylin And Eosin ◽

Safranin O

ABSTRACT Objective: To define histological scores for intervertebral disc degeneration that would enable the definition of morphological characteristics of disease, besides improving knowledge of the lumbar degenerative disc disease by means of immunohistochemical markers. Methods: Hematoxylin and Eosin, Alcian/PAS, Masson Trichrome and Safranin O/FCF staining was used on the intervertebral disc degeneration sections of patients with lumbar degenerative disc disease. The protein markers defined in immunohistochemistry were cell proliferation (Ki-67) and apoptosis (p53). Results: The study data enabled the determination of Safranin O/FCF stain as the most effective one for evaluating parameters such as area, diameter, and number of chondrocyte clusters. The importance of using stains in association, such as Safranin O/FCF, Masson Trichrome, Alcian/PAS and Hematoxylin and Eosin, was also determined, as they are complementary for the histopathological verification of intervertebral disc degeneration. By expressing proteins using the immunohistochemistry technique, it was possible to consider two stages of disc degeneration: cell proliferation with chondrocyte cluster formation, and induction of apoptosis. Conclusion: This study enabled the histological and immunohistochemical characterization to be determined for lumbar degenerative disc disease, and its degrees of evolution, by determining new disc degeneration scores.

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Higher Risk of Intervertebral Disc Herniation among Neurosurgeons Than Neurologists: 15 Year-Follow-Up of a Physician Cohort

Journal of Clinical Medicine ◽

10.3390/jcm7080198 ◽

2018 ◽

Vol 7 (8) ◽

pp. 198

Author(s):

Wen-Cheng Huang ◽

Chao-Hung Kuo ◽

Jau-Ching Wu ◽

Yu-Chun Chen

Keyword(s):

Propensity Score ◽

Intervertebral Disc ◽

Disc Herniation ◽

Cox Regression ◽

Intervertebral Disc Herniation ◽

Research Database ◽

Matched Cohort ◽

Disc Disease ◽

One To One

High physical activity or workload has been associated with intervertebral disc degeneration. However, there is little data on physicians’ risks of disc disease. The study aimed to investigate the incidences of spinal problems among neurologists and neurosurgeons. A cohort of neurologists and neurosurgeons was derived from Taiwan’s national research database. During the study period, the incidences of intervertebral disc herniation or spondylosis among these specialists were calculated. Another one-to-one by propensity score matched cohort, composed of neurologists and neurosurgeons, was also analyzed. A Cox regression hazard ratio (HR) model and Kaplan-Meier analysis were conducted to compare the risks and incidences. The entire cohort comprised 481 and 317 newly board-certified neurologists and neurosurgeons, respectively. During the 15 years of follow-up, neurosurgeons were approximately six-fold more likely to develop disc problems than neurologists (crude HR = 5.98 and adjusted HR = 6.08, both p < 0.05). In the one-to-one propensity-score matched cohort (317 neurologists versus 317 neurosurgeons), there were even higher risks among neurosurgeons than neurologists (crude HR = 8.15, and adjusted HR = 10.14, both p < 0.05). Neurosurgeons have a higher chance of intervertebral disc disorders than neurologists. This is potentially an occupational risk that warrants further investigation.

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