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Stem cell therapy to treat degenerative disc disease.

อัพเดตเมื่อ: ม.ค. 18


Our spine, how does it work?

The spine is our body’s center support anatomy. It keeps us upright and joins the different parts of our bone to one another: our pelvis, shoulders, head, chest, arms and legs. Even if the spine is built of a chain of skeletons, it is flexible to come from spinal disks and elastic ligaments. [1]


Our spine has many features: it supports the weight of your arms, torso, and head, and allows our body to move in every direction. Some parts of the spine are more flexible than other parts. The maximum flexible part is the neck area. The bones that build into the spine also protect our spinal cord, which runs through the spinal canal.



The discs work as the shock absorbers between the bones of the spine and are created to help the back stay flexible while resisting tremendous forces in many different planes of motion. Each disc contains two parts:


  • A tough firm outer layer called annulus fibrosus. The outer part of this layer contains nerves. If the disc breaks in this area, it may become pretty painful.

  • A jellylike, softcore called the nucleus pulposus. This part of the disc contains proteins that can provoke other tissues they touch become tender and swollen. If these proteins leak out to the nerves of the outer part of the disc, they can lead to a great deal of pain.

Unlike other tissues in our body, the disc has a very small blood supply. Once a disc is damaged, it cannot regenerate itself, and a whorl of degeneration can put in with three stages that seem to happen over 20 to 30 years:


Causes of Degenerative Disk Disease


Many factors can make discs to degenerate, which include age. Other specific factors, such as:

  • The drying out of the disc. At the time we were born, the disc has about 80 percent water. As we age, the disc dries out and loses their ability to absorb shocks as well.

  • Injuries, which can cause soreness, swelling, and instability. This can occur in low back pain.

  • Sport and daily activity, which create tears in the outer part of the disc. By age 60, most people encounter some degree of spinal disc degeneration. Not everyone at this age experiences back pain, however.

Degenerative disc disease, what are the symptoms?


The stereotype of a person with degenerative disc disease is an active person, or else healthy and in his or her 30s or 40s.


Common symptoms of degenerative disc include:

  • Pain relief while walking or even running than while standing or sitting for long periods.

  • Feeling better, lying down, or changing positions often.

  • Periods of acute pain that come and go. These continue from a few days to a few months before the pain relief. They can range from mild discomfort to severe pain. Pain can trouble the low back, thighs, and buttocks or the neck, related to where the affected disc is, and anxiety can also radiate to the arms and hands.

  • Pain is increased when sitting. When we are seated, the discs of the lower back have triple more load on them than when standing.

  • Pain that gets worse when lifting, twisting, or lifting.

  • Tingling and numbness in the arms and legs.

  • Weakness in the muscle of the leg or foot drop, an early sign of damage to the nerve root.

Degenerative Disc Disease Prevention


How to take care of your spinal disc health.

  • Keep a good posture – avoid slumping in your chair, crouching over a desk, or standing with your shoulders hunched.

  • Take a short break from sitting every 30 minutes.

  • Avoid sling bags, carry larger loads in a comfortable backpack using both shoulder straps and.

  • Stop smoking – it's believed smoking decrease the blood supply to the discs between the vertebrae, and this may lead to these discs degenerating disease. [3]

One of the most effective ways to decrease the chance of back pain is to strengthen your back muscles. Follow these rules to prevent back pain and protect your back :

  • Back-strengthening and stretching exercises such as yoga at a minimum of 2 days a week.

  • Sit and stand up straight.

  • Keep away from heavy lifting. If you do lift something substantial, keep your back straight and bend your knees. Follow this procedure, your leg muscles will manage most of the work.

  • Be active and eat a healthy diet. Being overweight can stress your back. Eating healthy and getting active can help you stay at a healthy weight. [2]

Treatment Option for Degenerative Disc Disease


Treatment for degenerative disc disease generally starts with noninvasive methods that may give sufficient symptom relief. [3]


Nonsurgical Treatment

  • Pain relief strategy focuses on decreasing pain from the damaged disc and helping you back to your routine activities. Methods of pain control such as pain relief medications, electrical stimulation, steroid injections, heat/ice therapy, or back braces.

  • Physical therapy can help strengthen and stretch the back support muscles to let the back heal and decrease the frequency of painful aggravated.

  • Lifestyle modifications, for example, changing your posture, giving up smoking or losing weight, can sometimes help decrease stress on the damaged disc and slow down degeneration progression.

Surgical Options

Surgical treatment is available for people who experience severe pain or a significant reduction of function and don’t respond well to other types of procedures. The surgery may involve cutting and replacement of either a part or the whole of the affected disc (partial or total disc replacement). Another way is disc removal (discectomy) and fuses the spinal discs together which limited the movement in the damaged spine part.


Possible complication from spine surgery

Accompanied by any operation, there is the risk of side effects. When surgery is done close to the spinal cord and spine, these complications can be very severe. Complications may involve subsequent pain and disability and the need for correction surgery. You should talk about the difficulties related to operation with your doctor before surgery. The list of complications given here is not a complete list of complications and is not a replacement for discussing the risks and benefits of surgery with your orthopedist. Only your doctor can evaluate your problem and tell you of the dangers of any medical procedure he or she may suggest. [4]

  • Anesthesia side effects: Most spinal surgery requires general anesthesia. A minute number of patients might have problems with this treatment. These could be problems from issues arising from your other medical conditions, reactions to the drugs used, and complications due to the anesthesia. Be sure to talk about these complications with your anesthesiologist.

  • Thrombophlebitis: When blood clots form inside the leg veins, it called Deep Venous Thrombosis (DVT). This is a frequent problem after many types of surgery. Why do we worry about this problem? Blood clots within the deep veins of the legs prevent the normal flow of venous blood from the legs return to the heart. This is one of the reasons why it is better for the prevention of DVT than lets a serious complication happen.

  • Infection: Any time surgery is performed, there always a risk of disease. Anyway, infections happen in less than 1% of spinal surgeries.

  • Hardware Fracture: In many different types of spinal surgery plates, metal screws, and rods are utilized as a part of the surgery to hold the spine in alignment while the wound heals. These metal tools are called "hardware." Once the bone heals, the hardware is generally not doing much of anything. Sometimes before the surgery is completely cured, the equipment can either move - or break from the right position. Known as a "hardware fracture." If this happens, it may need a repeat operation to either replace the hardware or remove the device.

  • Spinal Cord Injury: Any time you do surgery on the spine, there is some risk of damage to the spinal cord. This can cause a severe injury to the nerves or dura part (the covering of the spinal cord). Our spinal cord is a pillar of nerves which joins our brain to the rest of our body, let us control our movements. The nerve fibers in our spinal cord branch off to build pairs of nerve roots that travel along the tiny openings between our spine. The nerves in each part of the spinal cord join to a specific area of our body. Injury to the spinal cord can create disability in particular areas and not others, related to which spinal nerves are injured.

  • Persistent Pain: Some spinal surgery is merely unsuccessful. One of the most common side effects of spinal operation is that it can’t erase all of your pain. In some cases, it might be possible to increase your pain. Be aware of this risk before surgery and talk it at length with your orthopedist. He or she will be able to discuss with you some idea of the likelihood that you may not get the relief that you hope.

  • Sexual Dysfunction: The spinal nerve and spinal cord, sending the nerve signals that allow the entire of your body to function, feel sensation - and even have sex. Injury to the spinal nerve and the spinal cord can create many problems. If a nerve is injured is the one that connects to the pelvic region, it could cause sexual dysfunction.

Stem Cells Treatment for Degenerative Disc Disease


Cell-Based Therapies and Growth Factors in Lumbar Disc Degeneration.


While there are a variety of surgical and invasive options for the treatment of degenerative disc disease, recent attention has been pointing at the reversal and repair of disc degeneration of the affected disc. The various therapeutic method has been tested such as stem cells, biologic growth factors, and gene transplant. While these novel treatment modalities have shown, some promising results consider the reversal of the degenerative cascade. [5]


Do patients benefit from intraspinal Stem cell transplantation?


A total of 78 mesenchymal stem cell-treated participants were gathered into the six cohort studies with a follow-up time of 6 to 72 months. These participants have shown a mean significant improvement in the Oswestry disability index (ODI) and visual analog scale (VAS) versus the controls (if present). However, this improvement appeared limited to a group of 51 responders (65.4%). In most researches, disc height assessed by MRI did not restore; nevertheless, Pettine et al. (2015) reported an improvement of at least one Pfirrmann grade in eight participants at 12 months MRI follow-up. [8]



Possible Complication of Intradiscal Injection


Risks of the procedures, like any surgery, these procedures carry some risks:

  • Damage to nearby tissues and nerves

  • Failure to resolve pain

  • Need for further surgery

  • Infection

  • Damage to the disk

Intravenous stem cell therapy for the whole-body rejuvenation


Unlike the local treatment, systemic stem cell therapy can heal all areas in need at the same time. From the unique property of stem cells called “homecoming,” stem cells will receive the signal sending from the damage and inflame tissue and get to the problem site to repair the damaged tissue and organ. Moreover, systemic stem cell therapy is safe, and when the stem cells are delivered to the body intravenously, non-invasive procedure.






References

1. Institute for Quality and Efficiency in Health Care (IQWiG); 2006 Informed Health Care “How does the spine work?”

2. US department of Health and Human Services. Healthfinder.gov.” How to prevent back pain

3. John Hopkins Medicine. Conditions We Treat: Degenerative Disc Disease

4. University of Mary Land Medical Center. Complication of Spine Surgery.

5. Joseph Fernandez-Moure. Novel therapeutic strategies for degenerative disc disease: Review of cell biology and intervertebral disc cell therapy. SAGE Open Medicine Volume 6: 1–11

6. Regenerative Medicine Approaches for Engineering a Human Hair Follicle Gail K. Naughton, in Principles of Regenerative Medicine (Third Edition), 2019

7. Kentaro Yoshida, Placenta Power: For Health and Beauty A useful guide for those seeking placenta-based remedies

8. Markus Loibl1. Controversies in regenerative medicine: Should intervertebral disc degeneration be treated with mesenchymal stem cells? JOR Spine. 2019;2:e1043


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