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Published on: May 21, 2013
Intervertebral Disc Repair by Allogeneic Mesenchymal Bone Marrow Cells: A Randomized Controlled Trial
David C Noriega1, Francisco Ardura, Rubén Hernández-Ramajo
11 Hospital Clínico Universitario de Valladolid, Orthopedic Surgery Department, Spine Unit, Valladolid, Spain. 2 Hospital Clínico Universitario de Valladolid, Radiology Department, Valladolid, Spain. 3 Citospin S.L., Parque Científico de la Universidad de Valladolid, Valladolid, Spain. 4 Hospital Universitario Virgen de la Arrixaca, Department of Hematology and Cell Therapy, Murcia, Spain. 5 Instituto de Biología y Genética Molecular (IBGM), Universidad de Valladolid and CSIC, Valladolid, Spain.
Allogeneic mesenchymal stromal cells (MSC) offer a convenient, non-surgical treatment for degenerative disc disease, improving pain and disc quality in responders. This therapy shows promise as a viable alternative to autologous MSC treatments.
Area of Science:
- Regenerative Medicine
- Orthopedics
- Biotechnology
Background:
- Degenerative disc disease (DDD) is a major cause of chronic low-back pain, impacting public health and quality of life.
- Surgical interventions for DDD can lead to complications like adjacent segment degeneration.
- Autologous mesenchymal stromal cell (MSC) therapies show promise but face logistical challenges.
Purpose of the Study:
- To evaluate the efficacy and safety of allogeneic bone marrow MSCs for treating chronic low-back pain due to lumbar DDD.
- To compare allogeneic MSC treatment with a sham procedure in a randomized controlled trial.
Main Methods:
- A randomized controlled trial involving 24 patients with chronic lumbar DDD unresponsive to conservative care.
- Intradiscal injection of allogeneic bone marrow MSCs (25 × 10 cells/segment) in the test group.
- Sham paravertebral anesthetic infiltration in the control group, with 1-year follow-up including pain, disability, quality of life, and MRI assessments.
Main Results:
- Allogeneic MSC therapy was feasible and safe, with indications of clinical efficacy.
- MSC-treated patients showed significant improvement in pain and function compared to controls, particularly in a responder subgroup (40%).
- Magnetic resonance imaging indicated improved disc degeneration (Pfirrmann grading) in the MSC group and worsening in the control group.
Conclusions:
- Allogeneic MSC therapy presents a logistically advantageous alternative to autologous MSCs for DDD treatment.
- The non-surgical intervention provides pain relief and enhances disc quality.
- This approach offers a simple, effective option for managing degenerative disc disease.
