Biologic therapies to enhance intervertebral disc repair

Regen Med. 2018 Jan;13(1):55-72. doi: 10.2217/rme-2017-0111. Epub 2018 Jan 22.

Abstract

Degenerative disc disease is a progressive, chronic disorder with strong association to pain, where the dysregulated tissue environment signals disc cells, thereby leading to a low inflammatory process and slow extracellular matrix degradation and fibrosis in a perpetual vicious cycle, generating a structural and functional failure of intervertebral disc joint (IVDJ). Among current biologic therapies, there is an emerging minimally invasive strategy that consists of infiltrating plasma rich in growth factors, a safe and efficacious therapeutic approach for other musculoskeletal degenerative conditions. This review summarizes the homeostasis and degeneration of IVDJ, discusses some results on basic science and therapeutic use of platelet-rich plasma products and advances an alternative minimally invasive biologic therapy in IVDJ degeneration and chronic back pain.

Keywords: IVDJD; PRGF; PRP; disc–bone crosstalk; growth factors; inflammation; modic changes; plasma rich in growth factors; vertebral endplate.

Publication types

  • Review

MeSH terms

  • Animals
  • Cell- and Tissue-Based Therapy / methods*
  • Humans
  • Intercellular Signaling Peptides and Proteins / therapeutic use*
  • Intervertebral Disc / physiology*
  • Intervertebral Disc Degeneration / metabolism
  • Intervertebral Disc Degeneration / physiopathology
  • Intervertebral Disc Degeneration / therapy*
  • Plasma
  • Regeneration*
  • Regenerative Medicine / methods*

Substances

  • Intercellular Signaling Peptides and Proteins