Biologic Treatment of Mild and Moderate Intervertebral Disc Degeneration
Open Access
- 1 January 2014
- journal article
- review article
- Published by Springer Science and Business Media LLC in Molecular Medicine
- Vol. 20 (1), 400-409
- https://doi.org/10.2119/molmed.2014.00145
Abstract
Disc degeneration is the most common cause of back pain in adults and has enormous socioeconomic implications. Conservative management is ineffective in most cases, and results of surgical treatment have not yet reached desirable standards. Biologic treatment options are an alternative to the above conventional management and have become very attractive in recent years. The present review highlights the currently available biologic treatment options in mild and moderate disc degeneration, where a potential for regeneration still exists. Biologic treatment options include protein-based and cell-based therapies. Protein-based therapies involve administration of biologic factors into the intervertebral disc to enhance matrix synthesis, delay degeneration or impede inflammation. These factors can be delivered by an intradiscal injection, alone or in combination with cells or tissue scaffolds and by gene therapy. Cell-based therapies comprise treatment strategies that aim to either replace necrotic or apoptotic cells, or minimize cell death. Cell-based therapies are more appropriate in moderate stages of degenerated disc disease, when cell population is diminished; therefore, the effect of administration of growth factors would be insufficient. Although clinical application of biologic treatments is far from being an everyday practice, the existing studies demonstrate promising results that will allow the future design of more sophisticated methods of biologic intervention to treat intervertebral disc degeneration.This publication has 100 references indexed in Scilit:
- Exhaustion of nucleus pulposus progenitor cells with ageing and degeneration of the intervertebral discNature Communications, 2012
- Porcine Intervertebral Disc Repair Using Allogeneic Juvenile Articular Chondrocytes or Mesenchymal Stem CellsTissue Engineering, Part A, 2011
- TNF-α and IL-1β Promote a Disintegrin-like and Metalloprotease with Thrombospondin Type I Motif-5-mediated Aggrecan Degradation through Syndecan-4 in Intervertebral Disc*Journal of Biological Chemistry, 2011
- Cell transplantation in lumbar spine disc degeneration diseaseEuropean Spine Journal, 2008
- PDGF, bFGF and IGF-I stimulate the proliferation of intervertebral disc cells in vitro via the activation of the ERK and Akt signaling pathwaysEuropean Spine Journal, 2007
- Biological treatment strategies for disc degeneration: potentials and shortcomingsEuropean Spine Journal, 2006
- Clinical experience in cell-based therapeutics: intervention and outcomeEuropean Spine Journal, 2006
- Regeneration of intervertebral disc by mesenchymal stem cells: potentials, limitations, and future directionEuropean Spine Journal, 2006
- The vertebral endplate: disc degeneration, disc regenerationEuropean Spine Journal, 2006
- Senescence in human intervertebral discsEuropean Spine Journal, 2006