Department of Orthopaedics, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074, Aachen, Germany.
Department of Spine Surgery, Eifelklinik St. Brigida, Kammerbruchstraße 8, 52152, Simmerath, Germany.
Int Orthop. 2019 Apr;43(4):1027-1036. doi: 10.1007/s00264-018-4218-y. Epub 2018 Nov 10.
A systematic review of the literature was conducted to clarify the outcomes of autologous mesenchymal stem cells (MSC) injections for the regeneration of the intervertebral disc (IVD).
The following databases were accessed: PubMed, Medline, CINAHL, Cochrane, Embase and Google Scholar bibliographic databases. Articles including previous or planned surgical interventions were excluded. Only articles reporting percutaneous autologous MSC injection to regenerate IVD in humans were included. We referred to the Coleman Methodology Score for the methodological quality assessment. The statistical analysis was performed using Review Manager Software 5.3.
After the databases search and cross-references of the bibliographies, seven studies were included in the present work. The funnel plot detected low risk of publication bias. The Coleman Methodology Score reported a good result, scoring 61.07 points. A total of 98 patients were enrolled, with 122 treated levels. All the patients underwent conservative therapies prior to injection. A remarkable improvement in the quality of life were reported after the treatment. The average Oswestry Disability Index (ODI) improved from "severe disability" to "minimal disability" at one year follow-up. The visual analogue scale (VAS) showed an improvement of ca. 30% at one year follow-up. Only one case of herniated nucleus pulposus was reported. No other adverse events at the aspiration or injection site were observed.
This systematic review of the literature proved MSC injection to be a safe and feasible option for intervertebral disc regeneration in the early-degeneration stage patients. Irrespective of the source of the MSCs, an overall clinical and radiological improvement of the patients has been evidenced, as indeed a very low complication rate during the follow-up.
系统地回顾文献，阐明自体间充质干细胞（MSC）注射治疗椎间盘再生的结果。
检索了 PubMed、Medline、CINAHL、Cochrane、Embase 和 Google Scholar 等数据库。排除了包含先前或计划手术干预的文章。仅纳入报告经皮自体 MSC 注射以再生人类椎间盘的文章。我们参考 Coleman 方法学评分评估方法学质量。使用 Review Manager 软件 5.3 进行统计分析。
在数据库搜索和参考文献交叉引用后，本研究纳入了 7 项研究。漏斗图检测到发表偏倚的风险较低。Coleman 方法学评分报告了一个良好的结果，得分为 61.07 分。共纳入 98 例患者，共治疗 122 个节段。所有患者在注射前均接受了保守治疗。治疗后生活质量显著改善。平均 Oswestry 残疾指数（ODI）在一年随访时从“严重残疾”改善为“轻度残疾”。视觉模拟评分（VAS）在一年随访时改善约 30%。仅报告了 1 例椎间盘突出病例。在抽吸或注射部位未观察到其他不良事件。
本系统综述证明，MSC 注射治疗早期退变阶段患者的椎间盘再生是一种安全可行的选择。无论 MSC 的来源如何，患者的临床和影像学整体均得到改善，且在随访期间并发症发生率非常低。
