Document Detail

Intervertebral disc regeneration or repair with biomaterials and stem cell therapy - feasible or fiction?
MedLine Citation:
PMID:  22653467     Owner:  NLM     Status:  In-Data-Review    
The "gold standard" for treatment of intervertebral disc herniations and degenerated discs is still spinal fusion, corresponding to the saying "no disc - no pain". Mechanical prostheses, which are currently implanted, do only have medium outcome success and have relatively high re-operation rates. Here, we discuss some of the biological intervertebral disc replacement approaches, which can be subdivided into at least two classes in accordance to the two different tissue types, the nucleus pulposus (NP) and the annulus fibrosus (AF). On the side of NP replacement hydrogels have been extensively tested in vitro and in vivo. However, these gels are usually a trade-off between cell biocompatibility and load-bearing capacity, hydrogels which fulfill both are still lacking. On the side of AF repair much less is known and the question of the anchoring of implants is still to be addressed. New hope for cell therapy comes from developmental biology investigations on the existence of intervertebral disc progenitor cells, which would be an ideal cell source for cell therapy. Also notochordal cells (remnants of the embryonic notochord) have been recently pushed back into focus since these cells have regenerative potential and can activate disc cells. Growth factor treatment and molecular therapies could be less problematic. The biological solutions for NP and AF replacement are still more fiction than fact. However, tissue engineering just scratched the tip of the iceberg, more satisfying solutions are yet to be added to the biomedical pipeline.
Scw Chan; B Gantenbein-Ritter
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Publication Detail:
Type:  Journal Article     Date:  2012-05-31
Journal Detail:
Title:  Swiss medical weekly     Volume:  142     ISSN:  1424-3997     ISO Abbreviation:  Swiss Med Wkly     Publication Date:  2012  
Date Detail:
Created Date:  2012-06-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100970884     Medline TA:  Swiss Med Wkly     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  0     Citation Subset:  IM    
University of Bern, Switzerland;
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