Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
Cells. 2022 Feb 9;11(4):602. doi: 10.3390/cells11040602.
Intervertebral disc (IVD) degeneration is a common cause of low back pain and most spinal disorders. As IVD degeneration is a major obstacle to the healthy life of so many individuals, it is a major issue that needs to be overcome. Currently, there is no clinical treatment for the regeneration of degenerated IVDs. However, recent advances in regenerative medicine and tissue engineering suggest the potential of cell-based and/or biomaterial-based IVD regeneration therapies. These treatments may be indicated for patients with IVDs in the intermediate degenerative stage, a point where the number of viable cells decreases, and the structural integrity of the disc begins to collapse. However, there are many biological, biomechanical, and clinical challenges that must be overcome before the clinical application of these IVD regeneration therapies can be realized. This review summarizes the basic research and clinical trials literature on cell-based and biomaterial-based IVD regenerative therapies and outlines the important role of these strategies in regenerative treatment for IVD degenerative diseases, especially disc herniation.
椎间盘(IVD)退变是导致腰痛和大多数脊柱疾病的常见原因。由于 IVD 退变严重影响许多人的健康生活,因此需要克服这一主要问题。目前,对于退变的 IVD 的再生没有临床治疗方法。然而,再生医学和组织工程学的最新进展表明,基于细胞和/或基于生物材料的 IVD 再生疗法具有潜力。这些治疗方法可能适用于处于中间退变阶段的 IVD 患者,此时活细胞数量减少,椎间盘的结构完整性开始崩溃。然而,在这些 IVD 再生疗法能够临床应用之前,还有许多生物学、生物力学和临床挑战需要克服。本综述总结了基于细胞和基于生物材料的 IVD 再生疗法的基础研究和临床试验文献,并概述了这些策略在 IVD 退行性疾病(特别是椎间盘突出症)再生治疗中的重要作用。