Journal
STEM CELLS TRANSLATIONAL MEDICINE
Volume 11, Issue 5, Pages 490-503Publisher
OXFORD UNIV PRESS
DOI: 10.1093/stcltm/szac013
Keywords
intervertebral disc degeneration; cell transplantation; discogenic cells; discectomy; lumbar disc herniation
Categories
Funding
- National Natural Foundation of China [81772399]
- Beijing Municipal Science & Technology Commission [Z121107001012096]
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The treatment of intervertebral disc degeneration is a challenge. This study combines surgery and cell therapy to evaluate the safety and feasibility of autologous discogenic cells transplantation combined with discectomy in treating lumbar disc herniation. The results show that this combined treatment can slow down disc degeneration and reduce surgical complications.
The treatment of intervertebral disc degeneration (IVDD) is still a huge challenge for clinical updated surgical techniques and basic strategies of intervertebral disc regeneration. Few studies have ever tried to combine surgery and cell therapy to bridge the gap between clinical and basic research. A prospective clinical study with a 72-month follow-up was conducted to assess the safety and feasibility of autologous discogenic cells transplantation combined with discectomy in the treatment of lumbar disc herniation (LDH) and to evaluate the regenerative ability of discogenic cells in IVDD. Forty patients with LDH who were scheduled to have discectomy enrolled in our study and were divided into the observed group (transplantation of autologous discogenic cells after discectomy) and control group (only-discectomy). Serial MRI and X-ray were used to evaluate the degenerative extent of index discs, and clinical scores were used to determine the symptomatic improvement. No adverse events were observed in the observed group, and seven patients in the control group underwent revisions. Both groups had significant improvement of all functional scores post-operatively, with the observed group improving more considerably at 36-month and 72-month follow-up. The height and water content of discs in both groups decreased significantly since 36 months post-op with the control group decreased more obviously. Discectomy combined with autologous discogenic cells transplantation is safe and feasible in the treatment of LDH. Radiological analysis demonstrated that discogenic cells transplantation could slow down the further degeneration of index discs and decrease the complications of discectomy.
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