Stem Cell Therapy for Spine Surgery
Spinal surgery for spinal stenosis often involves fusion, using either an autograft, where bone is taken from the patient themselves, or an allograft, where donor-derived bone is used. A combination of the two is sometimes used, where the structural piece of bone used as the main graft material is packed with some of the patients’ own bone removed as part of the procedure itself. This is thought to give the graft a better success rate in terms of fusion, and represents a very basic form of stem cell therapy. Stem cell therapy has been used for many years in this kind of surgery, although it is rarely thought of in the context of cutting edge technology as it relies on the same principles as bone-marrow transplants which have become standard practice in some conditions.
In 2011 stem cell therapy with spine surgery hit the headlines as Republican nominee candidate Rick Perry underwent an experimental stem cell spine surgery procedure, purportedly out of the country due to regulations in the US preventing his treatment closer to home. Whether his stem cell back surgery affected his performances in candidate debates is still unknown. Whereas Rick Perry’s stem cell surgery involved injections of stem cells into his spine after back surgery, more routine stem cell spine surgery concentrates on the use of bone grafts.
World’s First Stem Cell Spine Surgery?
Albee is thought to be the first surgeon to use bone taken from the patient themselves to perform spinal stabilization – surprisingly, perhaps, this took place in 1911. In the same year, Hibbs also documented cases where he used bone taken from a patient’s iliac crest to correct spinal tuberculosis. Recent advances in the sourcing of stem cells has major implications for the success of procedures and the development of less invasive methods of treating such things as disc herniation, cervical facet joint disease, and other degenerative spinal conditions.
Clinical Trials Using Stem Cells
Stem cell clinical trials are underway looking at the potential for new delivery mechanisms, new stem cell sourcing, and culturing, and optimizing and their effects on successful rehabilitation and recovery of pathology in the spine. Treatments for disc regeneration may not be far away with several companies vying for the first marketable stem cell product approved for non-surgical, injection therapy to heal damaged discs and restore intervertebral height without the need for invasive intervention. Osteocel, Trinity Evolution, and NeoFuse are all names to watch in this area with trials either recruiting or already underway utilizing stem cells in spine conditions. Regenexx are also conducting trials using stem cell injections to treat disc herniations (pictured). Patients with spinal stenosis facing spinal surgery may wish to discuss these treatments with their consultant in order to assess their eligibility, should they be so inclined, to take part in those trials actively recruiting participants for stem cell therapy for spine surgery.
UPDATE – May 2012: Biotechnology company Mesoblast Ltd. is recruiting patients with degenerative disc disease for a trial looking at stem cell therapy for chronic lumbar back pain.