Stem cells in preclinical spine studies.
BACKGROUND
The recent identification and characterization of mesenchymal stem cells have introduced a shift in the research focus for future technologies in spinal surgery to achieve spinal fusion and treat degenerative disc disease. Current and past techniques use allograft to replace diseased tissue or rely on host responses to recruit necessary cellular progenitors. Adult stem cells display long-term proliferation, efficient self-renewal, and multipotent differentiation.


OBJECTIVE
This review will focus on two important applications of stem cells in spinal surgery: spine fusion and the management of degenerative disc disease.


METHODS
Review of the literature.


METHODS
Relevant preclinical literature regarding stem cell sources, growth factors, scaffolds, and animal models for both osteogenesis and chondrogenesis will be reviewed, with an emphasis on those studies that focus on spine applications of these technologies.


RESULTS
In both osteogenesis and chondrogenesis, adult stem cells derived from bone marrow or adipose show promise in preclinical studies. Various growth factors and scaffolds have also been shown to enhance the properties and eventual clinical potential of these cells. Although its utility in clinical applications has yet to be proven, gene therapy has also been shown to hold promise in preclinical studies.


CONCLUSIONS
The future of spine surgery is constantly evolving, and the recent advancements in stem cell-based technologies for both spine fusion and the treatment of degenerative disc disease is promising and indicative that stem cells will undoubtedly play a major role clinically. It is likely that these stem cells, growth factors, and scaffolds will play a critical role in the future for replacing diseased tissue in disease processes such as degenerative disc disease and in enhancing host tissue to achieve more reliable spine fusion.
Department of Orthopaedic Surgery, University of Virginia, PO Box 800159, Charlottesville, VA 22908-0159 USA.
Brian C
BC
Werner
Department of Orthopaedic Surgery, University of Virginia, PO Box 800159, Charlottesville, VA 22908-0159 USA.
Xudong
X
Li
Department of Orthopaedic Surgery, University of Virginia, PO Box 800159, Charlottesville, VA 22908-0159 USA. Electronic address: fhs2g@virginia.edu.
Francis H
FH
Shen
D000328:Adult; D053687:Adult Stem Cells / Q000502:physiology / Q000637:transplantation*; D000818:Animals; D020219:Chondrogenesis / Q000502:physiology; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000628:therapy*; D045164:Mesenchymal Stem Cell Transplantation; D023421:Models, Animal; D010012:Osteogenesis / Q000502:physiology; D013123:Spinal Fusion / Q000379:methods*; D054457:Tissue Scaffolds
Adipose derived stem cells; Bone morphogenic protein; Degenerative disc disease; Growth factors; Intervertebral disc; Scaffold; Spine fusion; Stem cells