Spine and Stem Cell Treatments An Innovation in Biological Science providing hope to back pain sufferers
The ultimate goal for patients with back pain caused by degenerated structures in the spine such as discs and facet joints or paralysis resulting from spinal cord injury is to find a solution to repair these structures using natural biological methods without the need for major surgery or artificial implants. Major surgery often carries a significant risk during the operation itself or problems that can be associated later with artificial implants such as wear or loosening.
Spinal discs act like cushions between bones and when healthy are well hydrated with plenty of gel (nucleus) and a strong outer covering (annulus). Disc degeneration occurs when there is a loss of spinal disc cells, which are normally found in the nucleus to keep the disc healthy, or loss of gel that keeps the disc well hydrated. Disc degeneration may be the result of natural aging or maybe the result of disease or damage to the disc. The loss of water (dehydrated) from a disc makes it less turgid (firm) and more prone to further problems related to the weakness of the disc structure. A dehydrated disc is identified as a black disc or flattened disc on MRI scan and is thought to be the precursor of most causes of back or neck pain because it provides less stability to that area of the spine. A disc problem can cause secondary micro-damage to other structures such as facet joints, core muscles and nerve endings which are all responsible for providing normal spine function. Poor spine function ultimately leads to progressive inflammation around nerve roots, weakness of muscles, facet joint deterioration, bone damage and chronic back pain.
Stem Cells are primitive (ie infant) cells that are naturally present in various parts of the body including Bone Marrow, Adipose (Body Fat) Tissue and Blood vessels. If placed in the correct location, these cells can grow into most other types of cells in the body. They have an amazing ability to sense their surroundings and automatically grow into the correct surrounding cell type. They also have the ability to recruit healing factors from other parts of the body in order to repair damage in their vicinity. Unfortunately, the number of these cells declines after the age of 25 and their potential to repair tissue becomes weaker with older age. The decline of these “magic” precursor cells may explain why healing is much better when you are younger than when you are older.
Recent studies have shown the remarkable potential for stem cells to repair degenerated discs by increasing the amount of water the disc can absorb thereby improving the shock absorbing capability and preventing the above described cascade of problems that ultimately lead to chronic back pain. The potential for repair is usually better in the early stages of disc degeneration before more significant secondary changes develop. Stem cells can replenish the spinal disc cells which normally regulate disc function and produce the gel which keeps the disc strong and stable.
Stem Cells can be extracted under local anaesthetic with a needle from areas of the body with plenty of bone marrow such as the pelvic bone or from body fat tissue by a procedure called lipo-aspiration. These cells can be sent to the laboratory for multiplication or storage or they be immediately concentrated and used for regenerative spine and joint treatments. The procedure is usually perfomed as a day case at a specialist centre. The procedure is relatively painless and some benefits are realised very quickly after the procedure. Stem cells can also be obtained from storage banks or cultured specifically for individual patients. This form of pure stem cell therapy is highly regulated and only available at very few licensed centres in the world and is still considered experimental.
Stem cells injected into the spine have shown only limited success in being able to repair spinal cord damage to reverse paralysis and only in some animal studies have there been convincing results. However there is immense work in this field and various regenerative techniques combining minor surgery and stem cell injections may offer better results in spinal cord injury treatment.
On the other hand, stem cell treatment of back pain from disc and facet joint degeneration has shown more promising results. Many studies in the past have shown that human disc cells can not be grown and multiplied in the laboratory and also they can produce new disc tissue. By replenishing the absent spinal disc cells in the nucleus with stem cells that can develop into disc cells there is potential to improve spinal disc nutrient content and recover disc hydration. This may lead to improved shock absorbing capacity, strengthening of muscles and restoration of normal spine function. Stem cells also have the ability to directly reduce inflammation and recruit other natural healing factors to parts of the body that have wear and tear. There have been reports of significant relief of back pain in patients having these type of cells injected into their spines.
Although a lot more clinical research needs to be done to identify the true benefits of stem cells and potential dangers such as uncontrolled growth of cells, the early results of stem cell treatments look very promising in the areas of joint and spinal disc preservation if not regeneration and it is likely that specialist clinics with the appropriately qualified doctors and proper approved facilities will be offering a variety of regenerative treatments in the near future to patients seeking to avoid more major surgery.
Specialist in Minimally Invasive Spinal Surgery and Medical Director of The Spine Unit
Specialist in Spinal Surgery and previously worked as a consultant in Norway