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Mesenchymal stem cells have the ability to pre-differentiate to various tissues, in order to regenerate them. In this particular case they can be applied pre-differentiated to cartilage-producing cells, in combination with activated lymphocytes, by direct injection into the disc guided by fluoroscopy or tomography.
In the first instance, the cellular material controls the inflammatory process to stop the damage and generate an environment conducive to the repair of the compromised tissue.
The repair is accomplished by the transformation of the implanted stem cells into the target tissue: the cartilage present in the intervertebral disc. A disc repair process is then triggered that repairs the damage to the annulus fibrosus and contains the nucleus pulposus.
Our clinical experience has shown that 90% of patients experience a significant decrease in pain and an improvement in functionality within the first month of receiving the implant. Between 3 and 6 months, changes are observed in the MRI, increasing its volume and reducing the herniated component.
Patient AOE, a 72-year-old man complaining of significant LBP, referred mainly to the T12 to L3 vertebrae and inferior intervertebral disc degeneration. A, B and C are 3 consecutive images of a baseline MRI. D, E and F are 3 consecutive images at 6 months after treatment. The consecutive images are presented to decrease the bias of image evaluation for patient positioning or image slice level. Prior to treatment the AOE patient was unable to play golf. At 3 months after treatment, he was able to regain full playing ability.
It is a disease that is generated by the injury of the ring that cushions the weight between the vertebrae of the spine.
The rings or discs of the spinal column are formed by two anatomically distinct parts: the nucleus pulposus – a gelatinous mass located towards the center of the disc – and the annulus fibrosus, which circumscribes the nucleus and whose consistency is firmer.
When the disc herniates, the nucleus pulposus damages the annulus fibrosus and moves towards the nerve root. This situation is very uncomfortable and can radiate to the extremities, producing pain such as sciatica.
Aging, weight overload and genetic predisposition are some of the most important risk factors for the occurrence of herniation or protrusion of the intervertebral disc into the spinal canal or into the exit orifices of the nerve tracts.
A closer look leads us to understand that interdiscal damage can have different expressions. It can be contained (disc bulging or disc protrusion) or generate rupture of the annulus fibrosus (disc extrusion or disc sequestration).
Until now, herniated discs were treated by surgery to partially or totally remove the herniated disc and thus achieve decompression of the nerve tissue. It is an intervention that has the implicit risks of spinal surgery under general anesthesia. The success rate of the surgery depends, among other things, on the surgeon’s experience and the patient’s clinical conditions prior to surgery. Between 10 and 40% of the people who undergo surgery do not have favorable results after surgery and continue with symptoms such as pain, motor deficits and decreased functionality. Of this group of patients, between 3 and 12% will require a second surgery.
Conservative treatment uses anti-inflammatory medication of varying potency which may include local corticosteroid infiltrations. It can be combined with rehabilitation aimed at strengthening different muscle groups and postural re-education.