title: What is the clinical evidence on regenerative medicine in intervertebral disc degeneration?
abstract: OBJECTIVE
  This review aims to explore and summarize the current clinical evidence about the use of regenerative medicine such as mesenchymal stem cells or platelet-rich plasma in intervertebral disc regeneration, in order to clarify the state of art of these novel approaches.
  
  
  METHODS
  We performed a research of the available literature about regenerative medicine strategies aiming to prevent intervertebral disc degeneration. All preclinical trials and in vitro studies were excluded. Only clinical trials were critically analysed.
  
  
  RESULTS
  The manuscript selection produced a total of 7 articles concerning the use of regenerative therapies in intervertebral disc degeneration, covering the period between 2010 and 2016. Articles selected were 4 about the injection of mesenchymal stem cells-related results and 3 using platelet-rich plasma. The total population of patients treated with regenerative medicine strategies were 104 patients.
  
  
  CONCLUSIONS
  Regenerative medicine, such as the use of mesenchymal stem cells or platelet-rich plasma, in intradiscal disc degeneration has shown preclinical and clinical positive results. Randomized clinical trials studying the potential of MSCs intradiscal injection have not been conducted, and PRP effect has been studied only preliminarily. Additional more powered high-quality studies are needed to really appreciate the long-term safety and efficacy of regenerative medicine approaches in IDD.
authors.affiliation: Clinica Ortopedica-IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10, 16132, Genoa, GE, Italy. marco.basso24@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Basso
authors.affiliation: Clinica Ortopedica-IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10, 16132, Genoa, GE, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Cavagnaro
authors.affiliation: Clinica Ortopedica-IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10, 16132, Genoa, GE, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Zanirato
authors.affiliation: Clinica Ortopedica-IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10, 16132, Genoa, GE, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Divano
authors.affiliation: IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, MI, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Formica
authors.affiliation: Clinica Ortopedica-IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10, 16132, Genoa, GE, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Formica
authors.affiliation: Clinica Ortopedica-IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10, 16132, Genoa, GE, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Felli
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000628:therapy*; D045164:Mesenchymal Stem Cell Transplantation; D053657:Platelet-Rich Plasma; D044968:Regenerative Medicine
keywords: Intervertebral disc degeneration; Intervertebral disc regeneration; Mesenchymal stem cells; Platelet-rich plasma; Tissue engineering