Nikolaos Papadimitriou1,2, Hanna Hebelka3,4, Daphne Hingert3, Adad Baranto3,2, Helena Barreto Henriksson3,5, Anders Lindahl6,7, Helena Brisby3,2. 1. Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden nikolaos.papadimitriou@vgregion.se. 2. Department of Orthopaedics, Sahgrenska University Hospital, Gothenburg, Sweden. 3. Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 4. Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden. 5. Department of Clinical Immunology and Transfusion Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. 6. Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden. 7. Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden.
Abstract
PURPOSE: Degeneration of the intervertebral disc is considered to be central in pain pathogenesis in patients suffering from chronic low back pain (LBP). In recent years, the injection of mesenchymal stromal cells (MSCs) into the disc to arrest or reverse the degenerative process has been proposed as an alternative therapy. The aim of the present study was to investigate the feasibility of using iron-labeled MSCs for intradiscal injection in patients with long-standing LBP. METHODS: Ten patients (7 men, 3 women, mean age 40 years, range 26-53) with chronic LBP and confirmed disc degeneration on magnetic resonance imaging (MRI) were recruited from the waiting list for planned surgery. Injection of autologous, expanded, and iron-labeled bone marrow-derived MSCs (BM-MSCs) into 1 or 2 disc levels was undertaken. Follow-up consisted of monitoring of adverse events, regular MRI examinations, and collection of patient-reported outcome measures (PROMs) for a minimum of 2 years. RESULTS: No complications could be detected, neither clinically nor on MRI. No statistically significant improvement was seen for PROMs on a group level up to 2 years postinjection. Three of 10 patients opted to proceed with the initially planned surgery within the first year and 2 more within 3 years postinjection. CONCLUSION: Results from this pilot cohort study show that injection of autologous expanded iron-labeled BM-MSCs is a safe procedure, in accordance with the existing body of evidence. The clinical result warrants further larger studies. LEVEL OF EVIDENCE: 4 for therapeutic studies. This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery.
PURPOSE: Degeneration of the intervertebral disc is considered to be central in pain pathogenesis in patients suffering from chronic low back pain (LBP). In recent years, the injection of mesenchymal stromal cells (MSCs) into the disc to arrest or reverse the degenerative process has been proposed as an alternative therapy. The aim of the present study was to investigate the feasibility of using iron-labeled MSCs for intradiscal injection in patients with long-standing LBP. METHODS: Ten patients (7 men, 3 women, mean age 40 years, range 26-53) with chronic LBP and confirmed disc degeneration on magnetic resonance imaging (MRI) were recruited from the waiting list for planned surgery. Injection of autologous, expanded, and iron-labeled bone marrow-derived MSCs (BM-MSCs) into 1 or 2 disc levels was undertaken. Follow-up consisted of monitoring of adverse events, regular MRI examinations, and collection of patient-reported outcome measures (PROMs) for a minimum of 2 years. RESULTS: No complications could be detected, neither clinically nor on MRI. No statistically significant improvement was seen for PROMs on a group level up to 2 years postinjection. Three of 10 patients opted to proceed with the initially planned surgery within the first year and 2 more within 3 years postinjection. CONCLUSION: Results from this pilot cohort study show that injection of autologous expanded iron-labeled BM-MSCs is a safe procedure, in accordance with the existing body of evidence. The clinical result warrants further larger studies. LEVEL OF EVIDENCE: 4 for therapeutic studies. This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery.
Authors: Crystian B Oliveira; Chris G Maher; Rafael Z Pinto; Adrian C Traeger; Chung-Wei Christine Lin; Jean-François Chenot; Maurits van Tulder; Bart W Koes Journal: Eur Spine J Date: 2018-07-03 Impact factor: 3.134
Authors: David C Noriega; Francisco Ardura; Rubén Hernández-Ramajo; Miguel Ángel Martín-Ferrero; Israel Sánchez-Lite; Borja Toribio; Mercedes Alberca; Verónica García; José M Moraleda; Ana Sánchez; Javier García-Sancho Journal: Transplantation Date: 2017-08 Impact factor: 4.939
Authors: Christopher J Centeno; Hasan Al-Sayegh; Michael D Freeman; Jay Smith; William D Murrell; Rostyslav Bubnov Journal: Int Orthop Date: 2016-03-30 Impact factor: 3.075
Authors: Helena B Henriksson; Teresia Svanvik; Marianne Jonsson; Margret Hagman; Michael Horn; Anders Lindahl; Helena Brisby Journal: Spine (Phila Pa 1976) Date: 2009-01-15 Impact factor: 3.468