Stem Cells in Spine Surgery

When conservative efforts fail, spinal surgery is sometimes necessary. Stem cells are being investigated in many different forms for application in spinal surgery and orthopaedic surgery amongst many other possible applications. Traditionally, obtaining stem cells for spinal fusions required the harvesting of bone from the pelvis to place over the spine to improve the likelihood of a successful fusion. Recently, researchers and surgeons have sought other means of obtaining a successful fusion without the need to obtain this pelvic bone and the donor site morbidity associated with its harvest (pain, additional surgical time, increased risk of infection, delayed recovery etc). The success of a fusion is dependent on many factors, one of which is the environment created to encourage bony union. Without the proper matrix of cells, obtaining a fusion is exceedingly difficult. Osteoprogenitor cells (cells which help make new bone) are responsible for ensuring bone formation and subsequent fusion at the site of bone graft deposition.

Techniques to enhance the appropriate types of cells deposited to the bone graft site are showing extreme promise in obtaining a successful union of the bone. Stem cells can be obtained by aspirating them from the bone marrow of the pelvis with a large needle without a surgical incision instead of removing them along with a substantial amount of the bone from the pelvis. These cells are then concentrated in a centrifuge and injected over the bone graft site to enhance the cellular matrix's ability to consolidate, or heal, the bone together. Other techniques to obtain pluripotent stem cells (cells that can differentiate into many types of tissue depending on the surrounding environment-including bone) can be harvested from placental membranes and amniotic fluid known to be rich in these factors. Additionally, these tissues and cells derived from amniotic fluid have been shown to produce high-density bone (Atala et al). There are products available that have shown promise in increasing bone formation and enhancing the body's regenerative process after surgery without having to harvest tissue or cells from the pelvis or local bone.

Currently, many centers are conducting detailed research on the potential applications of stem cells in the treatment of a multitude of disorders. There appears to be promise in using stem cells for spinal fusions, treatment of tendonitis, cartilage and meniscal tears, in pain management via stem cell spinal injections, in urology for incontinence and inflammation as well as prostate disease, and as a dermal filler and to repair collagen in plastic surgery. Mesenchymal stem cells are known to be responsible for growth and regeneration of tissue. Unfortunately, their numbers decrease dramatically with age. By harvesting them from a rich source such as the placenta and amniotic fluid after childbirth, surgeons may be able to provide patients with an improved chance of successful fusion and tissue repair after surgery. At the Orthopaedic & Spine Institute, our surgeons are versed in all forms of treatment for orthopaedic and spinal disorders. They are adept at performing techniques to enhance the possibility of successful operative and non-operative treatment alike. Using state of the art techniques and science to guide them, they can offer the most effective treatments available to their patients. By keeping current with the literature, continuing to stay abreast of the improvments in science and technology, and subsequently implementing those scientific advances, such as stem cell application, they are helping to usher in a new era of enhanced surgical outcomes.

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Orthopaedic and Spine Institute
Texas Center for Athletes
21 Spurs Lane Suite 245
San Antonio, Tx.78240
888.40.BACK.NOW

 

 

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