Abstract
Intervertebral disc degeneration is strongly associated with chronic low back pain, a leading cause of disability worldwide. Current back pain treatment approaches (both surgical and conservative) are limited to addressing symptoms, not necessarily the root cause. Not surprisingly therefore, long‐term efficacy of most approaches is poor. Cell‐based disc regeneration strategies have shown promise in preclinical studies, and represent a relatively low‐risk, low‐cost, and durable therapeutic approach suitable for a potentially large patient population, thus making them attractive from both clinical and commercial standpoints. Despite such promise, no such therapies have been broadly adopted clinically. In this perspective we highlight primary obstacles and provide recommendations to help accelerate successful clinical translation of cell‐based disc regeneration therapies. The key areas addressed include: (a) Optimizing cell sources and delivery techniques; (b) Minimizing potential risks to patients; (c) Selecting physiologically and clinically relevant efficacy metrics; (d) Maximizing commercial potential; and (e) Recognizing the importance of multidisciplinary collaborations and engaging with clinicians from inception through to clinical trials.
Highlights
Lower back pain is a leading cause of disability worldwide and the third most expensive health condition in the United States, with estimated health care spending in excess of $80 billion annually.[1,2] It is a significant epidemiological and socioeconomic problem affecting quality of life, and is the most common, non-cancer reason for opioid prescription in the United States.[3]
Each disc is comprised of a central, proteoglycan-rich, gelatinous nucleus pulposus (NP), a peripheral, fibrocartilaginous annulus fibrosus (AF), and superiorly and inferior, hyaline cartilage end plates that interface with the vertebral bodies.[10]
The earliest degenerative changes typically manifest in the NP, where reductions in proteoglycan content and hydration compromise biomechanical function, leading to progressive degeneration of the entire intervertebral joint.[11,12]
Summary
Lower back pain is a leading cause of disability worldwide and the third most expensive health condition in the United States, with estimated health care spending in excess of $80 billion annually.[1,2] It is a significant epidemiological and socioeconomic problem affecting quality of life, and is the most common, non-cancer reason for opioid prescription in the United States.[3]. There has been significant recent interest in developing injectable cell-based therapies for the treatment of disc degeneration with the specific aim to stimulate tissue repair.[22] Such therapies represent a potentially low risk and low cost long term solution for a very large patient population, making them attractive from both clinical and commercial standpoints.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
