Werner Brian C, Li Xudong, Shen Francis H
Department of Orthopaedic Surgery, University of Virginia, PO Box 800159, Charlottesville, VA 22908-0159 USA.
Department of Orthopaedic Surgery, University of Virginia, PO Box 800159, Charlottesville, VA 22908-0159 USA.
Spine J. 2014 Mar 1;14(3):542-51. doi: 10.1016/j.spinee.2013.08.031. Epub 2013 Nov 15.
The recent identification and characterization of mesenchymal stem cells have introduced a shift in the research focus for future technologies in spinal surgery to achieve spinal fusion and treat degenerative disc disease. Current and past techniques use allograft to replace diseased tissue or rely on host responses to recruit necessary cellular progenitors. Adult stem cells display long-term proliferation, efficient self-renewal, and multipotent differentiation.
This review will focus on two important applications of stem cells in spinal surgery: spine fusion and the management of degenerative disc disease.
Review of the literature.
Relevant preclinical literature regarding stem cell sources, growth factors, scaffolds, and animal models for both osteogenesis and chondrogenesis will be reviewed, with an emphasis on those studies that focus on spine applications of these technologies.
In both osteogenesis and chondrogenesis, adult stem cells derived from bone marrow or adipose show promise in preclinical studies. Various growth factors and scaffolds have also been shown to enhance the properties and eventual clinical potential of these cells. Although its utility in clinical applications has yet to be proven, gene therapy has also been shown to hold promise in preclinical studies.
The future of spine surgery is constantly evolving, and the recent advancements in stem cell-based technologies for both spine fusion and the treatment of degenerative disc disease is promising and indicative that stem cells will undoubtedly play a major role clinically. It is likely that these stem cells, growth factors, and scaffolds will play a critical role in the future for replacing diseased tissue in disease processes such as degenerative disc disease and in enhancing host tissue to achieve more reliable spine fusion.
间充质干细胞的最新鉴定和特性研究使脊柱外科未来技术的研究重点发生了转变，以实现脊柱融合和治疗椎间盘退变疾病。当前和过去的技术使用同种异体移植物替代病变组织或依靠宿主反应募集必要的细胞祖细胞。成体干细胞具有长期增殖、高效自我更新和多能分化的特性。
本综述将聚焦于干细胞在脊柱外科的两个重要应用：脊柱融合和椎间盘退变疾病的治疗。
文献综述。
将综述有关干细胞来源、生长因子、支架以及用于成骨和软骨形成的动物模型的相关临床前文献，重点关注那些聚焦于这些技术在脊柱方面应用的研究。
在成骨和软骨形成方面，源自骨髓或脂肪的成体干细胞在临床前研究中显示出前景。各种生长因子和支架也已被证明可增强这些细胞的特性及最终的临床潜力。尽管其在临床应用中的效用尚未得到证实，但基因治疗在临床前研究中也已显示出前景。
脊柱外科的未来在不断发展，基于干细胞的技术在脊柱融合和椎间盘退变疾病治疗方面的最新进展很有前景，表明干细胞无疑将在临床上发挥重要作用。这些干细胞、生长因子和支架很可能在未来对于替代诸如椎间盘退变疾病等疾病过程中的病变组织以及增强宿主组织以实现更可靠的脊柱融合方面发挥关键作用。
