Biotechnologies in the Treatment of Degenerative Disc Disease of the Cervical Spine

Abstract

ABSTRACTDegenerative disc disease of the cervical spine is a common medical condition in the population with underlying aging, genetic, mechanical and environmental factors. It is characterized with structural collapse, osteophyte formation and loss of the loading function of the intervertebral disc. As a consequence a compression of neural structures is observed with axial neck pain, cervical radiculopathy and myelopathy.Currently, the cervical interbody fusion and artificial disc implantation are the available operative treatment options when medications and physiotherapy are ineffective. New strategies focusing on biologic modalities would be appealing. We review the advanced biotechnologies in the treatment of degenerative disc disease of the spine.Many studies are focused on therapeutic molecules capable to influence the biochemical and structural processes of intervertebral disc degeneration. These factors are categorized as anticatabolics, mitogens, chondrogenic morphogens and intracellular regulators. Another step that further opposes the simple injection of tissues with therapeutic molecules is gene therapy seeking to transfer genetic material into target cells, which in turn become in situ factories for the long-term production of desired proteins. The use of tissue-engineered intervertebral disc constructs may prove helpful when treating degenerative cervical disc disease. An in vitro technology designed to produce cartilage or bone with desired biomechanical properties to repair damaged tissues is available nowadays. In the near future the golden standard might be the replacement of the degenerated disc with biological rather than polymer or metal prostheses.However, the cost-effectiveness of the reviewed approaches has not been definitively established. Regardless of its efficacy, the safety and economic issues may ultimately determine whether these therapies are viewed as an acceptable alternative to the recent treatment options.