Orthopedic Spine Surgery
Dr. Nancy Reid
Background context Spinal fusion surgery is used to treat discogenic low back pain. It is the standard of care for degenerative disc disease. This review analyzed the efficacy of mesenchymal stem cell injections in comparison to lumbar fusion surgeries for the hopeful shifting the standard of care for this disease to provide a less invasive, less costly option of treatment.
Purpose The purpose of this article is to compare the efficacy of lumbar fusion surgery with injections of mesenchymal stem cells for the treatment of discogenic low back pain.
Study Design/Setting Literature Review
Method A search in Pubmed/MEDLINE and ClinicalTrials.gov was conducted for literature comparing results of percutaneous injections of mesenchymal stem cells and one or two-level lumbar fusion surgery. Search terms included discogenic low back pain and stem cell injections. Exclusions were animal-based studies and studies that evaluated the use of stem cells during lumbar fusion surgery. This search yielded twelve related articles with the four most relevant used as the basis for this clinical review. There were no conflicts of interest or financial compensation during this study.
Results Of the eight results, four studies deem percutaneous injections of mesenchymal
stem cells into discs as a suitable and seemingly equally effective option for the treatment of discogenic pain.
When considering which treatment offers the best outcome and is most cost-effective, the four studies appraised provide evidence for both lumbar fusion surgery and percutaneous injections of MSCs within one to three years of the procedure. Additional studies are needed to analyze further whether percutaneous injections of MSCs provide equal or more significant benefit than lumbar fusion surgery are still in need. Limitations of current studies small sample sizes and a lack of high-quality randomized control trials. These findings can be used in the clinical setting to provide options for an effective treatment that may prevent patients from needing a costly and invasive procedure.
Keywords: lumbar fusion, low back pain, bone marrow aspirate, mesenchymal stem cells, lumbar spine, spine surgery
Baudoin-Willem HB. Efficacy of Percutaneous Injections of Mesenchymal Stem Cells Versus Lumbar Intervertebral Fusion Surgeries in the Reduction of Discogenic Lumbar Spine Pain. Lynchburg Journal of Medical Science. 2020; 2(3).
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