Zhang Wupeng, Wang Daofeng, Li Hua, Xu Gaoxiang, Zhang Hao, Xu Cheng, Li Jiantao
School of Medicine, Nankai University, Tianjin, China.
Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China.
Front Bioeng Biotechnol. 2023 Jun 16;11:1155357. doi: 10.3389/fbioe.2023.1155357. eCollection 2023.
The meta-analysis aimed to estimate the efficacy of mesenchymal stem cells on lumbar discogenic pain in patients with intervertebral disc degeneration. A comprehensive literature search was conducted in the PubMed, Web of Science, Embase and Cochrane Library databases with predetermined search strategy up to 18 September 2022. The clinical studies focusing on evaluating the efficacy and safety of mesenchymal stem cells in patients with intervertebral disc degeneration were identified. The primary outcomes were changes of pain score and Oswestry Disability Index. The Newcastle-Ottawa Scale for cohort studies was used for quality assessment. Review Manager was used to conduct the statistical analysis. Pooled risk ratios were calculated based on the random effect model. Heterogeneity, subgroup, and publication bias analyses were also performed. There were 2,392 studies were identified in the initial search, and 9 eligible studies with 245 patients were eventually included in this review. The Visual Analogue Scale score was significantly lower in patients after receiving mesenchymal stem cells therapy (mean difference = 41.62; 95% confidence interval 24.32 to 58.93; Heterogeneity: I = 98%; < 0.01). And the pooled mean difference of Oswestry Disability Index was 22.04 from baseline to final follow-up points (95% confidence interval 8.75 to 35.33; = 0.001; Heterogeneity: I = 98%; < 0.001). The pooled reoperation proportion was 0.074 (95% confidence interval 0.009 to 0.175; Heterogeneity: I = 72%; < 0.01). There were no serious related adverse events associated with the therapy. The findings of this meta-analysis indicated that mesenchymal stem cells therapy may be effective in relieving pain and improving Oswestry Disability Index significantly in patients with lumbar discogenic pain. Mesenchymal stem cells therapy may also be associated with a lower risk of adverse events and reoperation rates.
这项荟萃分析旨在评估间充质干细胞对椎间盘退变患者腰椎间盘源性疼痛的疗效。采用预先设定的检索策略，截至2022年9月18日，在PubMed、科学网、Embase和Cochrane图书馆数据库中进行了全面的文献检索。确定了侧重于评估间充质干细胞对椎间盘退变患者疗效和安全性的临床研究。主要结局指标为疼痛评分和Oswestry功能障碍指数的变化。采用队列研究的纽卡斯尔-渥太华量表进行质量评估。使用Review Manager进行统计分析。基于随机效应模型计算合并风险比。还进行了异质性、亚组和发表偏倚分析。在初步检索中识别出2392项研究，最终本综述纳入了9项符合条件的研究，共245例患者。接受间充质干细胞治疗后患者的视觉模拟评分显著降低（平均差值=41.62；95%置信区间24.32至58.93；异质性：I²=98%；P<0.01）。从基线到最终随访点，Oswestry功能障碍指数的合并平均差值为22.04（95%置信区间8.75至35.33；P=0.001；异质性：I²=98%；P<0.001）。合并再手术比例为0.074（95%置信区间0.009至0.175；异质性：I²=72%；P<0.01）。该治疗未出现严重相关不良事件。这项荟萃分析的结果表明，间充质干细胞治疗可能对缓解腰椎间盘源性疼痛患者的疼痛和显著改善Oswestry功能障碍指数有效。间充质干细胞治疗也可能与较低的不良事件风险和再手术率相关。
