Potential Applications for Using Stem Cells in Spine Surgery

Tony      Goldschlager; Graham      Jenkin; Peter      Ghosh; Andrewr      Zannettino; Jeffrey      Victor Rosenfeld

Abstract

While the use of biologics as adjuncts for spine surgery is growing annually stem cells have yet to be approved for this clinical application. Stem cells have the unique ability to differentiate into a variety of musculoskeletal tissues including bone or cartilage. Moreover they have been shown to secrete growth factors that promote matrix repair and regeneration and can down regulate inflammation and immune cell functions. It is these combined activities that make stem cells attractive candidates for advancing current techniques in spine surgery and possibly mitigating those pathologies responsible for tissue degeneration and failure thereby minimising the need for surgical intervention at a later date. This review focuses on the characteristics of progenitor cells from different sources and explores their potential as adjuncts for both current and future applications in spine surgery. Where possible we draw on the experimental outcomes from our own preclinical studies using adult mesenchymal progenitor stem cells, as well as related studies by others to support our contention that stem cell based therapies will play a significant role in spine surgery in the future.

Keywords: Stem cell, spine surgery, mesenchymal stem cell, intervertebral disc, spine fusion, bone-cartilage-neural, immune modulatory properties, spinal diseases and disorders, progenitor cells, cell phenotypes, embryogenesis, clonogenic population of cells, fibroblast colony, adipose tissue, growth factors, cartilage, avascular nucleus pulposus, MESENCHYMAL PROGENITOR CELLS, AMNION EPITHELIAL CELLS, pregnancy tissue, amniotic fluid, amniotic membrane, anti-inflammatory properties, ischaemia, multi-potent, fusion surgery, disc regenerative therapies, myelopathy, Allogeneic cell transplantation, immune co-stimulatory, Mixed Lymphocyte Reaction, dendritic cells, pain, mechanical aetiology, flexion, hand dexterity, LUMBAR VERSUS CERVICAL, disadvatage of reducing foraminal height, Disc replacement, Holy Grail, surgical armamentarium, osteoblasts, rheumatoid arthritis, osteoinductive agents, POSTEROLATERAL LUMBAR FUSION, spondylolisthesis, MICRODISCECTOMY, DISC ARTHOPLASTY, bio-scaffold, INFLAMMATION, immunosuppressive cytokines, interleukin, nerve fibres, analgesic effect of stem cell therapy