Future Uses of Mesenchymal Stem Cells in Spine Surgery

Gregory A. Helm, M.D., Ph.D.; Zulma Gazit, Ph.D.


Neurosurg Focus. 2005;19(6) 

In This Article

Abstract and Introduction

Stem cells are currently being studied for use in numerous clinical applications, ranging from neurodegenerative diseases to cardiac insufficiency. The use of mesenchymal stem cells (MSCs) in spine surgery is also compelling, especially with the increasing age of the general population. In this review the authors discuss the use of MSCs for intervertebral disc repair and regeneration and for use in spinal arthrodesis procedures. Clearly, the routine use of cellular therapies by spine surgeons to improve outcome after a variety of surgical procedures is rapidly approaching.

Numerous research groups are currently focusing on the purification and expansion of pluripotent stem cells for the treatment of a variety of disorders, including Parkinson disease, stroke, cardiomyopathy, hepatic failure, and renal disease.[1] Mesenchymal stem cells have also been identified and are currently being developed for bone, cartilage, muscle, tendon, and ligament repair and regeneration.[3,7,9,21,37] These MSCs are typically harvested, isolated, and expanded from bone marrow or adipose tissue, and they have been isolated from rodents, dogs, and humans.[8,10,12,38] Interestingly, these cells can undergo extensive subcultivation in vitro without differentiation, magnifying their potential clinical use.[8] Human MSCs can be directed toward osteoblastic differentiation by adding dexamethasone, ascorbic acid, and β-glycerophosphate to the tissue culture media. This osteoblastic commitment and differentiation can be clearly documented by analyzing alkaline phosphatase activity, the expression of bone matrix proteins, and the mineralization of the extracellular matrix.[6]