Innovative Biological Treatment Methods for Degenerative Disc Disease.

Publication Type	Review
Authors	Kirnaz S, Singh S, Capadona C, Lintz M, Goldberg J, McGrath L, Medary B, Sommer F, Bonassar L, Härtl R
Journal	World Neurosurg
Volume	157
Pagination	282-299
Date Published	01/01/2022
ISSN	1878-8769
Keywords	Biological Products, Biomechanical Phenomena, Intervertebral Disc Degeneration, Therapies, Investigational
Abstract	Low back pain is the leading cause of work absences and years lived with disability, and it is often associated with degenerative disc disease. In recent years, biological treatment approaches such as the use of growth factors, cell injections, annulus fibrosus (AF) repair, nucleus pulposus replacement, and tissue-engineered discs have been explored as means for preventing or reversing degenerative disc disease. Both animal and clinical studies have shown promising results for cell-based therapy on the grounds of its regenerative potential. Clinical data also indicate that stem cell injection is safe when appropriately performed, albeit its long-term safety and efficacy are yet to be explored. Numerous challenges also remain to be overcome, such as isolating, differentiating, and preconditioning the disc cells, as well as managing the nutrient-deficient and oxygen-deficient micromilieu of the intervertebral disc (IVD). AF repair methods including devices used in clinical trials have shown success in decreasing reherniation rates and improving overall clinical outcomes. In addition, recent studies that combined AF repair and nucleus pulposus replacement have shown improved biomechanical stability in IVDs after the combined treatment. Tissue-engineered IVDs for total disc replacement are still being developed, and future studies are necessary to overcome the challenges in their delivery, efficacy, and safety.
DOI	10.1016/j.wneu.2021.09.068
PubMed ID	34929786