Introduction

Welcome from Dwight Tyndall, MD, FAAOS

Intervertebral disc (IVD) degeneration is part of the cascade that can lead to back pain and other pathologies such as spinal stenosis and facet arthropathy in the lumbar spine. Current treatment involves nonsurgical options such as physical therapy, medications, selected injections—if indicated—and lumbar fusion.

Recently, there has been increasing interest in reparative treatments, which would allow patients to maintain their natural anatomy and avoid ablative treatment, such as lumbar discectomy and fusion. Although human clinical trials are scarce, there is a plethora of basic science research on the possible use of mesenchymal stem cells (MSCs) in the reparative treatment of intervertebral disc degeneration.

The journal articles presented in this issue of SpineScan explore recent research and the efficacy of MSCs in intervertebral disc regeneration.

Key Considerations

• Fusions do not address the cause of degenerative disc disease (DDD)

• MSCs increased disc space in animal models of DDD

• Type II collagen produced by transplanted MSCs may act as a framework (nucleus pulposus)

• Bone morphogenetic protein (BMP-13) linked to more nuclear cells

• Nanofibrous matrix could aid in disc regeneration

• Hydrogels are ineffective

• Clustered cells proliferate more slowly