Intervertebral disc degeneration and regenerative medicine

Mariam Farag, Rogina Rezk, Hunter Hutchinson, Alina Zankevich, Brandon Lucke-Wold
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Abstract

Intervertebral disc (IVD) degeneration is a common phenomenon that affects patients with increasing prevalence with increasing age. Both conservative treatments, such as the use of pain medication or physical therapy, and surgical treatments, such as fusion or disc replacement therapies, are offered to patients. Both non-invasive and invasive treatments have been shown to improve pain and quality of life for patients. This review explores the role of regenerative medicine techniques as a promising therapeutic intervention that can be used before or in combination with conservative therapy and surgery to enhance the treatment process in patients with IVD degeneration or disc pathology. Currently, there are four major modules of regenerative medicine: genetic therapy, platelet-rich plasma therapy, stem cell transplantation and tissue engineering. Several research studies have shown promising outcomes of stem cell transplantation and tissue engineering when combined with either surgical or conservative treatment, resulting in improved pain outcomes. The additional benefit of regenerative medicine techniques, specifically stem cell transplantation, is the potential for treating the root pathology of degeneration. Regenerative medicine techniques also have the potential to either halt or reverse degeneration as opposed to current standards of care for managing symptoms. There is a plethora of current research highlighting the benefits of regenerative medicine techniques; however, there remains clinical concerns and ethical concerns regarding the use of regenerative therapy techniques such as stem cell transplantation in the context of IVD degeneration.

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椎间盘退变与再生医学
椎间盘(IVD)退变是一种常见现象,患者的患病率随着年龄的增长而增加。患者既可接受保守治疗,如使用止痛药或物理疗法,也可接受手术治疗,如融合术或椎间盘置换疗法。非侵入性和侵入性治疗均可改善患者的疼痛和生活质量。本综述探讨了再生医学技术的作用,它是一种很有前景的治疗干预方法,可在保守疗法和手术之前使用或与之结合使用,以加强对 IVD 退化或椎间盘病变患者的治疗过程。目前,再生医学有四大模块:基因治疗、富血小板血浆治疗、干细胞移植和组织工程。多项研究表明,干细胞移植和组织工程与手术或保守治疗相结合,可改善疼痛治疗效果。再生医学技术(特别是干细胞移植)的另一个好处是可以治疗退化的根本病理。与目前控制症状的护理标准相比,再生医学技术还有可能阻止或逆转退化。目前有大量研究强调了再生医学技术的益处;然而,在IVD退化的情况下使用干细胞移植等再生治疗技术,仍然存在临床问题和伦理问题。
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