Clinical trials of intervertebral disc regeneration: current status and future developments

Area of Science:

• Regenerative Medicine
• Orthopedics
• Biologics

Background:

• Low back pain (LBP) is often caused by intervertebral disc degeneration (IDD).
• Current surgical treatments for LBP do not address the underlying disc degeneration.
• Biological interventions aim to regenerate the intervertebral disc (IVD) by restoring cellular function and matrix components.

Purpose of the Study:

• To review current clinical trials on biological approaches for IVD regeneration.
• To evaluate the efficacy of cell-, growth factor-, and small molecule-based therapies for IDD.
• To explore alternative strategies for treating IDD and LBP.

Main Methods:

• Review of clinical trials investigating cell-based therapies (mesenchymal stromal cells).
• Review of clinical trials investigating growth factor-based therapies.
• Review of clinical trials investigating small molecule-based therapies.

Main Results:

• Intradiscal delivery of mesenchymal stromal cells has shown positive outcomes in reducing pain and physical disability associated with IDD.
• Growth factor- and small molecule-based therapies are still in preliminary stages of investigation.
• Observed efficacy of cell-based therapies in human trials is less pronounced than in animal studies.

Conclusions:

• Mesenchymal stromal cell transplantation is a viable strategy for managing IDD and LBP.
• Potentiating endogenous disc progenitor cells presents a promising alternative to cell transplantation.
• Further large-scale, high-quality, long-term clinical trials are necessary to confirm the safety and efficacy of these regenerative therapies.