Stem Cells for Disc Regeneration?

by Chris Centeno, MD /

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stem cells for disc regeneration

Across the Internet right now, you can find countless websites advertising stem cells for disc regeneration. Is this for real or is it a scam? A recent patient post on our RIP fusion blog can help explain what’s real and what’s likely not.

What Is a Degenerated Disc?

The reason for trying to regenerate a disc is that a disc can degenerate (degenerative disc disease, or DDD). This means that it loses its ability to hold onto water and then slowly collapses. During this process, the whole spinal segment gets sloppy, with too much movement. This is known as degenerative instability.

degenerated discWhy does this happen? There are living cells inside the disc that produce a chemical (called glycosaminoglycan, or GAG) that holds onto water. This ability to retain water is key to the normal function of the disc as a shock absorber that lives between vertebra bones. When the cells inside the disc begin to die off, less GAG is produced and the disc can no longer “plump up,” so it collapses like a leaking water balloon.

Why Are Stem Cells for Disc Regeneration Being Offered?

disc regeneration researchIn animals like rabbits, several studies have shown that injecting culture-expanded mesenchymal stem cells can regenerate a degenerated disc—meaning stem cells for disc regeneration are a theoretical possibility. This has led some physicians to believe that a same-day stem cell procedure can regenerate human discs. There’s just one problem: disc regeneration really isn’t happening yet in humans.

There’s a huge difference between a rabbit and a human disc. First, rabbits walk on all fours, and humans are bipeds that walk upright. As a result, the structure of our discs is entirely different. In addition, experimental studies create a rabbit degenerated disc by sticking what would be the equivalent of a ball-point-pen-sized instrument into the center of the disc and sucking out the cells and GAG gel that lives there. This isn’t how human degenerated discs are made, as they occur over years to decades. For example, few patients have ever walked into my clinic and said, “Aliens abducted me last night and placed an instrument inside my disc to suck out the cells, and now my disc has collapsed…”

Back in 2005, based on what had been published, we were the first physicians to attempt using stem cells for disc regeneration. At first we used a same-day procedure, and when this didn’t work, we switched to culture-expanded stem cells (that had been grown in our lab) to more closely match the successful rabbit model. A funny thing then happened—NOTHING. Meaning we were unable to regenerate a single severely degenerated disc on follow-up MRI. While we were able to refine the technology to help patients with disc bulges and minimal degeneration, regenerating a human disc isn’t happening in multiple published clinical trials since 2005 (see disc stem cell study 1 and disc stem cell research 2).

Learning from a DDD Patient who Had Stem Cell Injections

A patient posted on our RIP low-back fusion blog that he had four severely degenerated low back discs with no disc space left. From 11 years of clinical experience, I have never seen a patient with severe degenerated disc disease respond well to having a same-day stem cell product (or even a culture-expanded one) placed into the disc. It was, therefore, no surprise that this expensive procedure didn’t work. Why?

As discussed above, a severely degenerated disc that has lost all of its height has few living cells inside it. In addition, the outside of the disc (called the annulus) that’s supposed to contain all of those cells is also ripped to shreds. While in theory, injecting stem cells inside the disc should help new cells grow, human degenerated discs are an incredibly hostile environment for cells to survive; hence, most cells placed there likely perish.

What Can be Done Using Regenerative Medicine for Patients with DDD?

First, as above, stem cell injections aren’t the answer. Second, websites offering to inject fibrin glue inside the disc to grow a new one are using a debunked technology that failed in FDA trials (but from the advertising, you would think the opposite). So right now, in 2016, there is no reliable way to regrow a severely degenerated disc. Having said that, we treat these all the time with good success. How?

degenerative disc disease stem cellsYou see, the disc is only part of the problem in DDD. Most of the pain isn’t coming from the degenerated disc, but instead from the joints in the back of the spine (facets), the spinal nerve that’s being irritated, and the fact that the ligaments and muscles are incapable of stabilizing the segment. Hence, why not focus on these areas? That’s what we’ve been doing with great success for years—injecting concentrated platelet mixes or lysates into these joints, around these nerves, and into the fried ligaments and muscles. We ignore the disc, and patients routinely benefit.

Finally, just because a severely degenerated disc can’t be regrown like new, doesn’t mean that stem cell treatments for discs are all bad. In fact, if you still have good disc height and a painful tear in the disc, a same day stem cell treatment may help quite a bit. Or if you have a bulging disc, specially cultured stem cells may help get rid of that bulge. It’s just severe disc degeneration that can’t be helped with stem cells at this point. The video below will help explain the different disc types in more detail.

The upshot? At the end of the day, don’t get burned by the idea that someone can regrow a severely degenerated disc—it isn’t going to happen. Instead, focus on what can be accomplished using regenerative medicine in 2016, which is quite a bit when you ignore the disc!

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11 thoughts on “Stem Cells for Disc Regeneration?

  1. Debra Perkins

    I have degenerative arthritis. Your article are very insightful and interesting. I too am always looking for that miracle cure, but know this isn’t out there. I loose cartilage in my joints causing bone on bone. Had my thumb reconstructed, and 8 months ago my left shoulder replaced. I have constant back pain as I have arthritis in the spine. I do find your articles making me hopeful for less pain in the future.

    1. Regenexx Team

      Debra,
      The goal is always less pain in the future so thankful to contribute to the hope! The trick is to get ahead of the process of breakdown. The Stem Cell Support Formula and the Curcumin Complex might help you get ahead of the curve:http://www.regenexx.com/regenexx-advanced-stem-cell-support-formula/ Has anyone looked into whether you are on any mediation that could be contributing to this process? See: http://www.regenexx.com/blog/diabetes-drugs-cause-severe-joint-pain/ and http://www.regenexx.com/blog/more-research-confirms-statin-drugs-cause-diabetes/

  2. KAE

    I am a patient with DDD. I can honestly say that the procedures described in this blog (platelet lysate, ligament prolotherapy) have been a lifesaver. I had a constant dull ache (sciatica type) and couldn’t stand for more than 5 mins at a time. This went on for months/years. I had vertebral segment instability (constant popping of my L5). With every treatment I improved. After 4 total treatments I can honestly say I have no more pain (ever) and no more instability. I no longer think about my back because there is no more pain. I am thankful for the regenerative procedures Regenexx provides. Without them, I know I would have had to have surgery and live with a constantly popping disc.

    Hopefully someday we will be able to re-establish disc height. But for now, I am doing great…

    1. Regenexx Team

      KAE,
      Thanks! Not needing to think about one’s back is such wonderful news!

  3. Sara

    For anyone reading this: I have had prolotherapy done to my neck for several years. I think that gains I made in stability to the spinal structures actually contributed to the disc or discs regaining better integrity. I couldn’t afford the PRP or Stem cells and would have gotten them if I could afford but I think that any of these regenerative treatments can work especially if done early. My pain level and functionality is much better. But it took three years minimum. I have no stake in the company except the desire to share my experience for good.

  4. Keith

    Very interesting article. I have had Platelet Rich Plasma (PRP) done on my facet joints four times over 2 years and it was a lifesaver! This article correctly states that the majority of the pain usually comes not from the disc — but from surrounding facet joints. I realized later on that I had TERRIBLE facet joint arthritis. It was not until I got the PRP that I started to feel improvement. It wiped out 90% of my pain and I thank God for it every day. No more pain pills! I am hopeful though that one of these companies (or Regenexx) will find the silver bullet — regenerating human discs someday.

    1. Regenexx Team Post author

      Keith,
      Wonderful to hear you’re doing so well! Always looking…

  5. Charlie

    I have DDD at L5/S1, and am trying to determine an intellegent proactive approach to my condition before it progresses beyond the reach of regenerative treatments. I am having a very difficult time finding objective information concerning the various spinal injections – PRP, platelet lysate, intradiscal PRP, stem cells, etc. Is there a reason (patent) why Regenexx seems to be the only provider of platelet lysate? I am in NYC where there is a plethora of specialists offering regenerative treatments for the spine, yet there is only one Regenexx provider in the area and those treatments are done in suburban NJ, which seems odd. Would it be possible to have a consult with the docs who are writing these articles?

    1. Regenexx Team Post author

      Charlie,
      Yes, Dr. Centeno writes the Blogs, and we can have our patient liaison team contact you and set up a Consulatation with him. That’s likely because we were the first to use Platelet Lysate and are now on our 4th Generation Platelet Lysate. This explains, though it was written back in 2014 when we were still using our 3rd Generation Platelet lysate. https://regenexx.com/blog/what-is-platelet-lysate/ and https://regenexx.com/blog/should-you-get-your-disc-injected-with-stem-cells/ and this link has a spine webinar, and alot of information about different spinal issues: https://regenexx.com/the-regenexx-procedures/back-surgery-alternative/

      1. Charlie

        Thank you so much.
        Please do contact me at the email addrsss I have provided in connection with my comments.
        I will review the resources you have linked.

        1. Regenexx Team Post author

          Charlie,
          We will.

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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