Stem cells are often referred to as our body’s own ‘repair kit’ and with good reason. Under the right conditions, these remarkable cells can produce any other type of tissue within their specific cell layer; with the most adaptable of all – embryonic stem cells – able to differentiate into any cell in the human body.
Stem cell therapy has been used for decades in the form of bone marrow transplants, helping the patient’s body to repopulate blood cells following chemotherapy and ablation of the bone marrow, but as scientists learn more about how stem cells work, the list of conditions that are – or may soon be – treatable with stem cells continue to grow. Unfortunately for many patients, treatment is restricted to those few who may be eligible to take part in a clinical trial. However, autologous stem cell therapies (during which the patient’s own cells are utilized) are available right now through various specialist centers throughout the country, including the Mississippi Stem Cell Treatment Center on the Gulf coast.
Common Causes of Back Pain
The spinal structure is one of the marvels of biology, simultaneously providing support and flexibility for the body while protecting the main trunk road of its central information highway – the spinal cord and its associated nervous infrastructure.
However, the spine is also vulnerable to the cumulative effects of misuse through bad posture, poor lifting technique and other damaging habits, not to mention trauma following road accidents, falls, sports activities and assault. In many cases these factors result in chronic pain during later life.
One of the most common causes of back pain is damage to the intervertebral discs (IVDs), soft tissue structures that sit between the vertebrae and act as the spine’s built-in shock absorbers, protecting the bones from the effects of compression and torsion. A normal disc consists of an tough annulus fibrosis, like a motorcycle tire, surrounding a soft, gelatinous center, the nucleus pulposus. Healthy IVDs are remarkably resilient but, as people age, their discs become less effective at producing the water-binding proteoglycans that give them their unique cushioning qualities and they begin to degrade. Stress and trauma can further produce tears in the annulus, allowing the nucleus to bulge, impinging on nerves, and leak irritant substances that cause nerve pain and spasm.
Current treatments for back pain usually involve painkillers, physiotherapy and sometimes invasive surgery. This commonly involves the removal of damaged tissue and the fusion of vertebrae, an operation which is often unsuccessful and fails to deal with the root of the problem. A newer modality is to perform discography, identify the tear and repair the annulus with fibrin glue, then inflate the nucleus like a tire.
Of course, disc problems are not the only cause of back pain; other culprits include torn muscles and tendons, arthritis (of the facets), bone fractures and pinched nerves (radiculopathy).
Stem Cells and the Link with Back Pain
Around a decade ago, there were whispers from within the field of regenerative medicine suggesting that stem cells may have a role to play in treating chronic back pain. Back in 2006, a team from the University of Manchester in the UK had found a way to coax mesenchymal stem cells to differentiate into nucleus pulposus tissue, the collagen-based gel-like substance comprising the hole of the doughnut in IVDs.
The British team were working on a treatment that would involve extracting MSCs from the patient, purifying and cultivating them and then embedding them in a gel to be later implanted back into the patient using an arthroscope. This extraction and redeployment procedure, in various guises, is now commonly offered by specialist centers (including the Mississippi Stem Cell Treatment Center) and is often referred to as autologous transplantation.
Two of the main benefits of autologous stem cell treatment are the absence of rejection (graft versus host disease) and the ability for patients to potentially benefit from therapy many years before an ‘off-the-shelf’ stem cell preparation is available. Another advantage for back pain sufferers is that the minimally-invasive nature of the procedure generally means they are in and out of the clinic within half a day.
Although autologous stem cell therapies are still – as American anesthiologist Dr Joseph Meyer Jr puts it – “Experimental, with a capital E,” the results that are emerging from early patient trials are promising to say the least.
For example, Meyer and his team have been following a group of 24 back pain patients for over two years as part of Phase I/II trials for autologous stem cell therapy. Half of those who received the therapy (there was no control group) subsequently underwent further procedures and could not be assessed; but of the rest, ten reported a reduction in pain over a period of two to four months, with five still experiencing less pain two years later (three reported no improvement with the other two still awaiting their follow-up). Most significantly for the future of stem cell therapy, the trials found no safety issues and none of the patients involved reported a worsening of their condition.
Meanwhile, other researchers are working on another potential route to back pain relief by studying how those stem cells found to actually reside in the intervertebral discs themselves might be stimulated to repair degraded tissue. It is currently thought that certain molecules act to block the IVDs own ability to regenerate and studies are ongoing with the aim of identifying and inhibiting them.
A Typical Procedure: Stem Cell Treatment for Back Pain
Each stem cell treatment center will employ its own specific methods and technologies for the extraction, treatment and re-deployment of mesenchymal stem cells. For example, whereas some centers will extract bone marrow from the iliac bone of the hip (often performed under general anesthesia because it is often an uncomfortable procedure), the Mississippi Stem Cell Treatment Center extracts MSCs from adipose cells via a short, minimally-invasive liposuction procedure, lasting no more than 20 minutes. One of the reasons for this is that stem cells are much more abundant in adipose tissue than in the bone marrow and studies suggest a link between stem cell quantity and efficacy of treatment. In addition, stem cells from bone-marrow aspirate often have to be expanded (cultured) prior to deployment owing to their fewer numbers (we are ready to reintroduce stem cells within 90 minutes of harvesting).
Deployment is carried out via injection, into the bloodstream (where stem cells are known to travel to the site of injury) and/or directly into the space of the disc. The precise nature of the patient’s back problem will also affect the specific treatment received. In severe cases, at the Mississippi Stem Cell Treatment Center, incorporate Extracorporeal Pulse Activation Technology (EPAT) to cause added attraction of reparative stem cells to the site of damage.
What about Spinal Cord Injury?
One of the most debilitating back injuries that humans can endure is a spinal cord injury (SCI) which, in its more severe form, can leave a patient completely paralyzed below the level of injury. Beyond the acute phase, and in the absence of any meaningful improvement from any treatment, it is worth employing autologous stem cell therapy since there is room and hope for improvement, especially if the spinal cord is not totally severed. There is plenty of research activity within this field and a number of trial patients have experienced significant improvements in motor control and sensation following injections of stem cells. SCIs are complicated by the fact that neurons and their supporting cells are generated within the ectoderm layer whereas the more easily extracted mesenchymal stem cells will, under natural conditions, mainly create cells from within the mesoderm layer (e.g. blood, bone, cartilage, muscle, etc.), although there are exceptions. Therefore, SCI trials tend to involve animal models or somatic stem cells from donor tissue for more standardization.
If you are currently suffering from degenerative disc disorder, facet arthropathy or another orthopedic or joint disease we suggest speaking to a member of our friendly team to discuss your back pain and what therapy options may be available for you. Please call (886) 855 4823 or visit website at http://www.gulfcoaststemcell.com where you will also find a list of conditions that may be appropriate for autologous stem cell therapy.