Long-Term Effectiveness of Intradiscal Culture-Expanded Mesenchymal Stem Cells (MSCs) with Platelet Products for...

Background/Objectives: Low back pain (LBP) remains one of the leading causes of disability globally and contributes significantly to healthcare expenditures. Discogenic LBP, a subtype stemming from intervertebral disc degeneration, often provesrefractory to conventional treatment modalities. Regenerative orthobiologic therapies, including platelet-rich plasma (PRP), platelet lysate (PL), and mesenchymal stem cells (MSCs), have emerged as promising alternatives, though long-term outcomes and safety profiles are not yet well understood. Methods: This case series reports 13 patients treated between 2015 and 2016 at an outpatient interventional pain center who received intradiscal culture-expanded MSC injections with or without additional injections to other surrounding vertebral structures. There was no control group. Inclusion required patients to have discogenic LBP with or without radiculopathy and at least six years of completed follow-up data. Outcomes were assessed using Numeric Rating Scale (NRS), Functional Rating Index (FRI), and modified Single Assessment Numeric Evaluation (SANE) scores at multiple time points up to 10 years post treatment. Results: Thirteen patients met the inclusion criteria. Significant reductions in NRS and FRI scores were observed at 6 months, 3 years, and 6 years (p < 0.01). At 6 years, the average NRS score decreased by 2.50 points, FRI by 24.14 points, and SANE showed a 60% improvement. At 10 years, among the seven patients who responded, average SANE improvement was 78.1%. No adverse events were reported. Conclusions: This study presents the longest known follow-up data for intradiscal MSC therapy for discogenic LBP, demonstrating sustained improvements in pain and function. These findings support further investigation into combination orthobiologic therapies as a viable long-term treatment option for chronic LBP.