Mesenchymal stem cell technology in the treatment of degenerative disc disease.
OBJECTIVE
Low back pain is the leading cause of disability and a major health problem around the world. As of today, symptomatic relief is the best option offered to patients, with mixed results. This study will review the use of mesenchymal stem cell (MSC) technology in the conservative and surgical treatments of degenerative disc disease (DDD).


METHODS
A series of PubMed-National Library of Medicine searches were performed. Only articles in English journals or with published with English language translations were included. Level of evidence of the selected articles was assessed.


RESULTS
There are multiple in-vitro and animal studies describing successful intervertebral disc (IVD) repair/regeneration with the use of live MSC therapy. Only 3 human studies (22 patients) with inconsistent results have been performed using bone marrow MSCs injected into diseased IVDs in patients with DDD. There exist multiple in-vitro and animal studies describing successful bony fusion with the use of MSC-containing bone graft substitutes. Only 3 retrospective human studies (115 patients) using CBM in spinal fusion have been performed with successful fusion rates ranging from 90.2%-92.3%. However, these studies lacked power and had significant conflicts of interest. There are multiple challenges with the use of MSC technology in humans.


CONCLUSIONS
MSCs may be a promising therapy in the treatment of DDD. However, their lack of success in human models leaves room for further research and focus in this field. Currently, there is no clinical evidence to support the use of this technology in the conservative or surgical management of patients with DDD.
Department of Neurosurgery Icahn School of Medicine at Mount Sinai New York, NY, USA - sheeraz.qureshi@mountsinai.org.
B
B
Skovrlj
G
G
Cunn
J Z
JZ
Guzman
S A
SA
Qureshi
D000818:Animals; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D017116:Low Back Pain / Q000209:etiology / Q000601:surgery; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*