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Published Online: 22 July 2014

A Systematic Review of the Safety and Efficacy of Mesenchymal Stem Cells for Disc Degeneration: Insights and Future Directions for Regenerative Therapeutics

Publication: Stem Cells and Development
Volume 23, Issue Number 21

Abstract

Intervertebral disc degeneration is associated with low-back pain. Mesenchymal stem cells (MSCs) have been used to “regenerate” the disc. The aim of this study was to perform a systematic review of comparative controlled studies that have assessed the safety and efficacy of using MSCs for disc regeneration. Literature databases were extensively searched. Trial design, subject-type, MSC sources, injection method, disc assessment, outcome intervals, and complication events were assessed. Validity of each study was performed. Twenty-four animal studies were included with 20.8% of the studies reporting randomization of groups. Trials in humans fulfilling inclusion criteria were not noted. The studies represented 862 discs that were injected with MSCs and 1,603 discs as controls. All three types of MSCs (ie, bone marrow, synovial, and adipose tissues) showed successful inhibition of disc degeneration. Bone-marrow-derived MSCs demonstrated superior quality of repair compared with other non-MSC treatments. A 2.7% overall complication rate was noted, whereby complications were noted only in rabbits. Overall, evidence suggested that MSCs increased disc space height in the majority of animal models. This is the first systematic review to assess the safety and efficacy of MSCs for the treatment of disc degeneration. Short-term MSC transplantation is safe and effective; however, additional, larger, and higher-quality studies are needed to assess the long-term safety and efficacy. Inconsistencies in methodological design and outcome parameters prevent any robust conclusions. Human-based clinical trials are needed. Recommendations are further made to improve efficacy, reduce potential complications, and standardize techniques for future studies.

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cover image Stem Cells and Development
Stem Cells and Development
Volume 23Issue Number 21November 1, 2014
Pages: 2553 - 2567
PubMed: 25050446

History

Published in print: November 1, 2014
Published ahead of print: 11 September 2014
Published online: 22 July 2014
Accepted: 22 July 2014
Received: 27 April 2014

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Rita Lok-Hay Yim
Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China.
Juliana Tsz-Yan Lee
Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China.
Cora H. Bow
Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China.
Björn Meij
Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
Victor Leung
Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China.
Kenneth M.C. Cheung
Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China.
Patrick Vavken
Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Harvard Center for Population and Development Studies, Harvard School of Public Health, Boston, Massachusetts.
Department of Orthopedic Surgery, University of Basel, Basel, Switzerland.
Dino Samartzis
Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China.

Notes

Address correspondence to:Dino SamartzisDepartment of Orthopaedics and TraumatologyThe University of Hong KongProfessorial Block, 5th Floor102 Pokfulam RoadPokfulamHong Kong, SARChina
E-mail: [email protected]

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No competing financial interests exist.

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