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Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science

Specialty

Neurosurgery and Physiatry

Advisor

Professor Elyse Watkins, DHSc, PA-C, DFAAPA

Abstract

ABSTRACT:

Purpose: The purpose of this article is to review the efficacy of cell-based therapies, such as Mesenchymal Stem Cells (MSCs) for the treatment of Low Back Pain (LBP) caused by Intervertebral Disc Degeneration vs. traditional treatments, such as conservative measures and surgery.

Method: A PubMed literature search was conducted with search terms “intervertebral disc degeneration”, “stem cell repair”, and “low back pain”. Sixteen pertinent articles were retrieved, and they serve as the basis for this clinical review.

Results: A lack of evidence-based research to recommend cell-based therapies at this time because the available studies lacked tools to assess treatment heterogeneity depending on patient characteristics, co-intervention or other factors. Also, sample sizes were small and therefore unlikely to accurately detect rare adverse events.

Conclusion: Low Back Pain (LBP) is usually associated with disc degeneration and is usually called degenerate disc disease (DDD), which is a common term for intervertebral disc (IVD) degeneration causing LBP. This process is caused by a decrease in disc nutrient supply, decreased oxygenation, lower pH, and loss of ability of the intervertebral disc to respond to increased load or injury. Cell-based therapies, such as autologous nucleus pulposus cell re-implantation, have in human trials shown improvements in LBP score, retention of hydration, and increased disc height. Also, multipotent mesenchymal stem cell (MSC) therapy has been proposed as a potential means to lessen discogenic LBP, by reducing nociceptive disc pain, slowing catabolic metabolism, and restoration of disc tissue.2 Unfortunately, it is too early to be able to recommend cell-based therapy for LBP due to IVD. Much more research is indeed needed, because the available studies lacked tools to assess treatment heterogeneity depending on patient characteristics, co-intervention or other factors.6 Therefore, to rigorously evaluate the efficacy and safety of cell-based therapies for IVD repair, high-quality multicenter, prospective, randomized trials still need to be conducted.

Keywords: “intervertebral disc degeneration”, “stem cell repair”, and “low back pain”.

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